Abstract:
Presentation of case: patient 36 years old, appealed to complaints about changing the color of the skin,
reducing body weight by 10 kg in 2 months, expressed general weakness, lowering blood pressure,
reducing sexual desire. Discussion: prescribed treatment: insulin therapy (aspart, degludec) day
dose 42 OD, levothyroxine 100 mcgr/day, vitamin E, selenium 100 mcgr, chorionic gonadotrophin
1500 OD intramuscularly once per week, monthly courses with the same break. After the therapy, the
patient’s condition improved. Repeatedly the patient appeared on the review 6 months after treatment.
Hyperpigmentation of the skin and natural areas of pigmentation are reduced, there is a stabilization of
blood pressure at a level of 120 / 70-110 / 70 mm Hg, reduction of clinical symptoms, achieved target level
of glycemia and hormonal blood parameters the target glycemia level was reached (4.6-5.1 mmol / L),
glycosylated hemoglobin (8.1%) and hormonal blood parameters (TTG 3.4 mmol / L) cortisol serum 1.7
μg / dl (norm 6.2-19.4 μg / dl), testosterone free 3.4 pg / ml (N 1.7-8.2), total testosterone - 12.28 (N 8.64
- 29 nmol / l), sex steroid binding globulin (CHD) (67 nmol / l, at the rate of 13-71 nmol / l, ), testosterone
free 8.9 pg / ml (N 8.8 - 42.5 pg / ml). Conclusions: Decomposition of adrenal insufficiency (decrease in
glucocorticoids as contrinsular hormone) can lead to untypical cours of diabetes with steaolyhipoglicemia
in autumne-summer period and normalizabionglycemia glycemia in winter-autumne period. Presents of
2-3 decompensate, endocrine diseases in the same moment suppresses pronounced typical symptomatics
each of them precedes with erased or disguised picture.
