Impact of glucocorticoid replacement therapy on carbohydrate metabolism in patients with Addison disease

Yassmine Abdelkafi; Khouloud Boujelben; Salah Dhoha Ben; Hamdi Frikha; Kacem Akid Faten Haj; Nadia Charfi; Mouna Mnif; Mohamed Abid; Mouna Elleuch; Majdoub Nabila Rekik

doi:10.1530/endoabs.110.EP15

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Endocrine Abstracts (2025) 110 EP15 | DOI: 10.1530/endoabs.110.EP15

ECEESPE2025 ePoster Presentations Adrenal and Cardiovascular Endocrinology (170 abstracts)

Impact of glucocorticoid replacement therapy on carbohydrate metabolism in patients with Addison disease

Yassmine Abdelkafi ¹ , Khouloud Boujelben ¹ , Dhoha Ben Salah ¹ , Hamdi Frikha ¹ , Faten Haj Kacem Akid ¹ , Nadia Charfi ¹ , Mouna Mnif ¹ , Mohamed Abid ¹ , Mouna Elleuch ¹ & Nabila Rekik Majdoub ¹

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¹Hedi Chaker University Hospital, Endocrinology Department, Sfax, Tunisia

JOINT2579

Introduction: In adults with Addison disease (AD), glucocorticoid replacement therapy is associated with an increased morbidity. The aim of our study was to assess the prevalence of carbohydrate metabolism disorders in patients with AD and identify its predictive factors.

Patients and methods: A cross sectional study including 50 patients diagnosed with AD with a mean duration of glucocorticoid replacement of 13,9 years. Biochemical markers of glucose metabolism were evaluated. The prevalence of type 2 diabetes and its complications were analyzed. Patients presenting type 1 diabetes were excluded from our study.

Results: The mean age of patients was 49,5 with a significant female predominance and a sex ratio of 0.25. Mean fasting blood glucose at the diagnosis of AD was 4,6 mmol/l and the mean glycated hemoglobin was 4,6%. No patient had prediabetes nor diabetes. At the time of our study, disorders of carbohydrate metabolism were found in 38% of patients and 31,6 % had type 2 diabetes. Diabetic retinopathy occurred in 2 patients and one patient complained of diabetic neuropathy. Daily and cumulative dose of glucocorticoids were higher in patients with diabetes compared to those with normal blood sugar level (27,5 mg/day vs 25,6 mg/day; 506,2 mg vs 355,4 mg). In addition, longer AD duration was found in patients presenting diabetes compared to those with a normoglycemia(19,8 years vs 13,2).

Conclusion: Despite the worldwide availability of replacement therapy in AD, exposure to supraphysiological dose of corticosteroids leads to altered insulin secretion and decreased hepatic and muscular insulin sensitivity resulting in risk exacerbation of carbohydrate metabolism disorders.