Apr 13, 2019
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Today I got so upset I smashed my head on metal. 😷💀
Drs Akshay Jain and Vivian Fonseca discuss the CATALYST trial.
Not necessarily a novel approach to treating type 2 diabetes but instead a disturbing finding that in ~ 25% of patients with type 2 diabetes and hypertension whose disease is poorly controlled on multiple medications, a significant cause of their insulin resistance is hypercortisolism of unclear etiology because by treating the hypercortisolism their insulin resistance improves.
Dr. Fonseca is an excellent clinician and researcher; I know him personally. What is the import of these findings?
I just LOVE having an undiagnosed (I think you’d consider it chronic) illness.
Like I went so long without puking and here we are 🤢 🤮
I’ve thrown up twice today and I’m getting nauseous! Plus I can’t find my anti-nausea medication. 🙃🙃🙃
So I may have Cushing's syndrome?
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Ugh, autoimmune diseases...
Having a cortisol attack/blowout due to my hypercortisolism really sucks. It’s 65°F in my house, and I’m overheated, sweating and stressing the fuck out over miniscule things. Yay, thanks body, I love when you kick me while I’m down. =_=
No sleep in days AND a cortisol overload? Is it Christmas already?
I also want to point out I do not have Cushings disease, which hypercortisolism is usually linked with. I’m a special, fucked up case.
Stress
= cortisol = me. Yeah!
Symptoms and effects of hypercortisolism
Facial acne--def have this right now...
Fat redistribution, e.g. truncal obesity, thinning of extremities, moon facies
Hypertension--scared to check mine
Immune suppression--better not! cannot risk getting sick before the big ole exam
Osteoporosis
Abdominal striae
Hyperglycemia
Emotional disturbance
^Self portrait. Jk. Obviously, my situation is not that extreme. People who have some constellation of these symptoms usually have something more serious going on--adrenal hyperplasia, pituitary adenoma, cancer somewhere that's secreting ACTH as part of a paraneoplastic syndrome, taking steroids as treatment for another disease, etc.
So, too much stress is no good! ...Yet not enough cortisol isn't good either...it's what keeps you alive after a stressful event like an illness, surgery, or trauma. So it's not much different from what we learned in middle school about emotional and physical well-being, haha. I swear, we learned everything important about life in elementary and middle school.
Hypercortisolism & Dexamethasone Suppresion Test