01-12-2011 11:41 PM
I have been a type 1 diabetic for over 26 years and currently use a Medtronic insulin pump for insulin administration. I've been using the pump for over 2 year. I believe the pump is advantageous in that it has the ability to provide fast-acting insulin (Humalog) on an hourly basis, and has the wizard calulator to determine dosages based on glucose level and carb intake. My current settings are a basal rate of 1.1U/ hr, and a bolus rate of 1U/ 8g carbs. My sensitivity is at 25, and my active insulin time is 5. My target range is set at 90-120mg/ dL.
I began taking the Adderrall a few months ago to treat incessant restlessness and racing thoughts. I have been diagnosed with the disorder through thorough evaluation based upon the criteria included in the DSM-IV as well as PET scans. I've tried other AD/HD medications including Strattera, methylphenidate (Ritalin), and Vyvanse, however the Adderall, for me, is the most effective medication to treat the symptoms. I also participate in psychosocial therapy. After 2 months of titration, including an impatient evaluation, I've found that 20mg of regular release Adderall, administered 3 times daily, is the optimal dosage.
Prior to beginning the Adderall, my blood sugar levels most often lied in the 80-130mg/ dL range. My latest hA1C, prior to taking the Adderall, was 6.5. I diligently count my carb intake prior to administering the insulin, and check my sugar levels 6 times, or more, each day. The settings on my pump were working well. However, after I started taking the Adderall, my blood sugars dropped significantly between the hours of 7:30AM and 6:00PM. It got to the point where I would have to frequently consume large amounts of carbs without taking a bolus dosage. Note that I take the quick release Adderall at 7AM, 12PM, and 3PM, and that the hypoglycemic episodes occur during these times. My blood glucose levels then stabilize to an acceptible range (80-120mg/ dL) after 6PM. During my recent inpatient hospitalization, this proposed Adderall-driven hypoglycemic phenomenon was witnessed, and recorded by hospital staff, including my psychiatrist, internal medicine doctor, and most importantly, endocrinologist. None of these doctors were aware of any correlation between d-amphetamine use and hypoglyemia in juvenile diabetics. A second opinion from a different endocrinologist also provided no explanation. I can find no scientific research related to the phenomenon via the web, or any medical publications. The Adderall website itself gave no incite in relation to this. No where I've looked has turned up any information on the contraindications of Adderall in relation to insulin administration and hypoglycemia.
PLEASE NOTE: My intention for this discussion is an attempt to attain the physiological theories of others in regard to why Adderall may increase insulin sensitivity, thus resulting in low blood sugar, and to correspond with others who may be currently, or have in the past, experienced the same symptom. I respectfully ask that opinions on whether or not AD/HD is a legitmate disorder not be offered. I am also not interested in opinions on whether or not stimulants, such as Adderall should be offered as a treatment. In regard to the low blood sugar levels I've been experiencing, I am working on this with my endocrinologist, so ideas or suggestions on how to correct this are undesired.
I have 2 theories as two why d-amphetamine may be responsible for low blood sugar levels. I am not a doctor and have little knowledge in concern to the medical practice, so these theories will be posited without much specific medical terminology.
My first theory (guess) is that the Adderall speeds up my metabolic rate resulting in the enhanced consumption of carbs and calories. Because the carbs are burned so quickly, I have a deficit of glucose to sustain normal blood sugar level.
My second theory (again- a guess) is that the Adderall results in an overactive thyroid. Because of the excessive secretion of T3 and T4 hormones, increased insulin sensitivity occurs. The increased insulin sensitivity, thus, results in hypoglycemia. When the Adderall runs its course at the 6PM hour, the thyroid returns to normal function. I have found multiple scientificall documented sources stating that d-amphetamine can cause hyperthyroidism. I have also found numerous scientific documents that state hyperthyroidism can cause increased insulin sensitivity in insulin dependant individuals. Therefore, the Adderall causes the hyperthyroidism, which in turn causes the elevated insulin sensitivity, which in turn causes the hypoglycemia. For my next lab work appointment, taken prior to my visit with my endocrinologist, I'm going to ask that my thyroid be tested.
I would appreciate any comments in regard to my theories, and would also like to hear any theories of your own. I would also welcome any experience you may have in regard to this issue, and would be thankful for any knowledge you can provide.
01-03-2013 01:44 PM
I just googled "does adderall lower blood sugar" and your post popped up. I have similar circumstances as yours and also pump with an animas pump. My blood sugar is not as well controlled as yours but, the adderall has a significant effect on my glucose readings. I had to lower my basal rates during the day. I experience alot of "dawn phenomenon" and taking adderall has decreased the frequency of that occurrence. My A1C went from a 9 to a 7 in 2 months, and that two months were the ones that I began the adderall treatment.
I also asked my endo about it and he had no answers, but he has had other patients who said the same thing. It is pretty cool and weird at the same time.
I am glad that you posted what you did. At least I am not the only one that has experienced the change!
01-03-2013 05:44 PM - edited 01-03-2013 05:48 PM
Editing to add: original post is from 2011
have been T1 over 40 years.
I have been on a pump for over 3 years.
I have been on generic adderall for about 2 years.
The prescribing practitioner warned me that adderall could cause hypoglycemia, because a primary side effect is that it suppresses your appetite. As I explained to her, hypoglycemia due to "not eating" should not happen, as I take bolus insulin based on the amount of carbs I am going to eat.
A welcome side effect FOR ME was that I did indeed lose weight. This weight loss has affected the amount of basal insulin that I need, and I have reduced the amount I take overall.
if I were having multiple episodes of hypoglycemia, I would start by doing a basal test ( see instructions in the shaded area at the top of this forum) to see if I needed to make adjustments. If I wanted to know if the adderall was somehow causing the lows, I would still start with a basal test And make sure those rates were correct. Then I would do ANOTHER basal test but omit the adderall that day.
I've learned it is very typical for both basal rates and insulin:carb ratios to need adjustments from time to time.
Diagnosed Type 1 at age 16 months, over 45 years now
Minimed pump and cgm since July '09. Metformin (insulin resistance), levothyroxine(thyroid), losartan (BP)
I have traveled cross country, and to Canada, UK, Kenya, Mexico, Jamaica, Equador/Galapagos islands, and lived in Egypt for a year.
01-04-2013 12:04 PM
I did find this article on Adderall and Diabetes. If it affects Type 2's then you would surely think it would affects Type 1's.
Under the Disease interactions, click on the word Diabetes. Hope this gives you information you can then pass on to your doctor(s). Doing the basel test should help you also so you can find out if you're working with the correct basel for your body, then go from there. Good luck!
Mother of Courtney, Dx'd Type 1 in 2006 at age 14.
01-05-2013 12:26 AM
It seems that you have a lot of people that agree with you that Adderall does indeed affect blood sugar levels. I am also going to say you may need to have more than one basal such as one for when you are on Adderall and another for night when you are not on Adderall. Basal testing is certainly in order here and also remember thatt you can have several basals depending on what you are doing at the time and also depending on what medications you are on at the time as well. Wishing you the best.
a Deaf person with Diabetes.
05-17-2013 02:28 AM
I completely agree with you!!!.... I think that you are right there is definitely a correlation I am not technically diabetic, but am prediabetic. I was just telling my grandma the other day that I felt the adderall was helping somehow with blood sugar control, because I stopped taking it for 3 days due to me forgetting it on my way to go see friends for 3 days the minute i got back though started taking my adderall XR again the next day I felt so much better there is some kind of mechanism of action I think and I think it has to do with the glucose counteregulatoy hormones -(epinephrine, GH, Thyroxine, Glucocorticoids, and G....) the adderall I saw increases levels of dopamine and serotonin as well as norepnephrine. I read though that the dopamine makes something called MOA-? More sensitive and I believe that could have some affect as well. I take adderall XR 2x daily 20mg each. There is something going on at first i though maybe I had some kind of mild SIADH, but still am not sure I could almost swear it has something to do with the hormone and possibly the adrenal medulla portion of the brain. I hope this helps you as well as encourages you to seek even more answers. There is definitely some correlation and I believe with adderrall if you have some kind of DM1 DM2 or insulin resistance it will work either in one direction or the other (this is why some people think it causes hyperglycemia and i believe for them that is prb true i think it just depends the direction it takes in the body) just like the side effects claim it can cause euphoria or depression it just I think is how your body fires off and uses those hormones in relation to the evels in the body. It has been helping me and I havent felt this good since I dont know when.
Also I think i saw where if the MOA was more sensitized then it would supress hepatic production of more glucose in glycogen storage meaning less build up in the live which is what people with the insulin resistance deal a lot with and most will take metformin as an oral hypoglycemic and this drug has a similer method of action.
05-17-2013 12:23 PM
I think your 1st theory could be correct. You may even be more active while on it, without noticing it. I would just continue to try to adjust my bolus and/or basal accordingly - maybe even do new basal and bolus testing while on Adderall. (I know how vital the med. is for genuine ADHD. )
I don't think the 2nd theory is correct because both of my kids have used Adderall for years, and both have Hashimoto's. They are now 18 and 22 years old. Their thyroid has always been low. They have been on Adderall for more than 10 years, and will probably be on it for life. Their Hashimoto's was diagnosed about 7 years ago. The two are totally unrelated for them.
Diagnosed with Diabetes Type 2 by mistake --1/26/11
Diagnosed correctly with Type 1-- 4/5/11 (just before 47th birthday)
using Animas pump and Dexcom cgm
Also have Diabetic Peripheral Neuropathy, Hashimoto's Thyroiditis, Asthma, Osteo Arthritis, Osteo Pinea, GERD, Hypersensitivity to irritants in environment (lungs, eyes), and Severe Obstructive Sleep Apnea