Yes, LOW blood sugar appears to be a definite factor in precipitating an adrenal crisis (See excerpt #1 below from  http://www.rch.unimelb.edu.au/publications/cah_book/ ), but I don't believe that is the correct association between CAH and diabetes, which is a condition involving HIGH blood sugar, the OPPOSITE problem. 

 

From my understanding, (and as Anon. also wrote) any association with CAH and diabetes would have to do with the steroids taken to treat the condition.  HC/prednisone/dexamethasone are all glucocorticoids.  Glucocorticoids have the effect of RAISING blood sugar levels, and continuous use of these steroids are thought to possibly contribute to insulin resistance, a symptom associated with diabetes.  Though rare, apparently there have been cases of diabetes that have been brought on through long-term use of glucocorticoids (See #2, below).

 

Some symptoms of diabetes do sound similar to symptoms of CAH---excessive thirst, excessive urination, tiredness, fatigue....to name a few.  However, though the symptoms might sound the same, I don't think they stem from the same physiologic cause.  ( I don't really know very much about this subject...have just read about this a little bit...so corrections will gladly be taken, if I am misunderstanding anything.)

 

EXCERPT # 1 

Salt-losers

In salt-losers, the enzyme deficiency in the adrenal glands is more severe than in the salt-losers. Their strong tendency to lose excessive amounts of salt in the urine, if uncontrolled, can cause acute dehydration, very low blood pressure, nausea and vomiting. The levels of salt (sodium and chloride) and sugar (glucose) in the blood fall, and the potassium level rises. This dangerous situation is referred to as an ‘adrenal crisis’. Very urgent medical treatment is needed as a life-saving measure.

Some patients with the salt-losing form of CAH receive very little warning of adrenal crises. Repetitive vomiting is often the first sign. Drowsiness is most likely to be due to an abnormally low blood sugar levels and if sugar is not given, may progress to loss of consciousness....

What causes an adrenal crisis?

The body usually responds to sickness (fever, infection or other illness) and physical injury by releasing more cortisol. This helps to boost the blood sugar and blood pressure, aiding recovery. In CAH, the adrenal glands are unable to make more cortisol. Therefore the body is less protected, and the effects of illness or injury may be more severe. Adrenal crises can be readily prevented (see the following section on Treatment of CAH).

 

EXCERPT #2 

 

1: Nurs Clin North Am 2001 Jun;36(2):333-9, viii

Glucocorticoid therapy and diabetes management.

Volgi JR, Baldwin D Jr.

Section of Endocrinology and Metabolism, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA. jvolgi@rush.edu

The use of glucocorticoids can worsen pre-existing diabetes and precipitate new steroid induced diabetes. The purpose of this article is to explain the effects of glucocorticoid therapy on diabetes management and to demonstrate how to achieve optimal diabetes control through several case studies.