Prevalence Of Thyroid Dysfunction In Patients With Diabetes Mellitus
Abstract Diabetes mellitus (DM) and thyroid dysfunction (TD) are the two most common endocrine disorders in clinical practice. The unrecognized TD may adversely affect the metabolic control and add more risk to an already predisposing scenario for cardiovascular diseases. The objective of this study was to investigate the prevalence of TD in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM). This is an observational cross-sectional study. Three hundred eighty-six (386) patients with T1DM or T2DM that regularly attended the outpatient clinic of the Diabetes unit, Hospital Universitário Pedro Ernesto, participated in the study. All patients underwent a clinical and laboratory evaluation. Thyroid dysfunction was classified as clinical hypothyroidism (C-Hypo) if TSH > 4.20 μUI/mL and FT4 < 0.93 ng/dL; Subclinical hypothyroidism (SC-Hypo) if TSH > 4.20 μUI/ml and FT4 ranged from 0.93 to 1.7 ng/dL; Subclinical hyperthyroidism (SC-Hyper) if TSH < 0.27 μUI/ml and FT4 in the normal range (0.93 and 1.7 ng/dL) and Clinical hyperthyroidism (C-Hyper) if TSH < 0.27 μUI/ml and FT4 > 1.7 μUI/mL. Autoimmunity were diagnosed when anti-TPO levels were greater than 34 IU/mL. The positive autoimmunity was not considered as a criterion of thyroid dysfunction. The prevalence of TD in all diabetic patients was 14,7%. In patients who had not or denied prior TD the frequency of TD was 13%. The most frequently TD was subclinical hypothyroidism, in 13% of patients with T1DM and in 12% of patients with T2DM. The prevalence of anti-TPO antibodies was 10.8%. Forty-four (11.2%) new cases of TD were diagnosed during the clinical evaluation. The forty-nine patients with prior TD, 50% with T1DM and 76% with T2DM were with normal TSH levels. We conclude that screening for thyroid dis Continue reading >>
Thyroid Disorders And Diabetes Mellitus
Mirella Hage , Mira S. Zantout , and Sami T. Azar * Division of Endocrinology, Department of Internal Medicine, American University of Beirut-Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon Division of Endocrinology, Department of Internal Medicine, American University of Beirut-Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon Division of Endocrinology, Department of Internal Medicine, American University of Beirut-Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon Division of Endocrinology, Department of Internal Medicine, American University of Beirut-Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon Received 2011 Jan 26; Accepted 2011 May 13. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Studies have found that diabetes and thyroid disorders tend to coexist in patients. Both conditions involve a dysfunction of the endocrine system. Thyroid disorders can have a major impact on glucose control, and untreated thyroid disorders affect the management of diabetes in patients. Consequently, a systematic approach to thyroid testing in patients with diabetes is recommended. Thyroid diseases and diabetes mellitus are the two most common endocrine disorders encountered in clinical practice. Diabetes and thyroid disorders have been shown to mutually influence each other and associations between both conditions have long been reported [ 1 , 2 ]. On one hand, thyroid hormones contribute to the regulation of carbohydrate metabolism and pancreatic function, and on th Continue reading >>
Low Thyroid Function And Type 2 Diabetes
Study finds hypothyroidism tied to type 2 diabetes. Having too little thyroid hormone in the blood–even in the low-normal range–raises the risk of developing type 2 diabetes, especially in people with prediabetes, a new study in nearly 8,500 people finds. Adults in the lowest third of thyroid function levels had a 1.4 time higher risk of progressing from prediabetes to type 2 diabetes than those in the highest third of thyroid function, according to a study presented at the Endocrine Society annual meeting. Dutch researchers used a cohort of adults without diabetes at baseline, ages 45 and older, and found those with higher thyroid-stimulating hormone had a 1.2-fold increased risk of developing diabetes. Patients diagnosed with prediabetes have a 40% greater likelihood of developing diabetes if they are also diagnosed with hypothyroidism. Layal Chaker, MD, of Erasmus Medical Center in Rotterdam, Netherlands, in his presentation, added that, “Low thyroid function is associated with higher risk of developing diabetes, but also the progression from prediabetes to diabetes and this is even within the normal range of thyroid function, “Low thyroid function as represented by higher TSH [thyroid-stimulating hormone] is with a 1.2-fold increased risk of diabetes and a 1.4-fold increased risk for progression from prediabetes.” She added that, over a lifetime, 70% to 75% of people diagnosed with prediabetes will progress to diabetes. Dr. Chaker presented the results at ENDO 2016. Thyroid hormone is important for metabolism, and thus important in controlling weight and cholesterol metabolism. Therefore, Dr Chaker and her team hypothesized that thyroid hormone could also be important in the development of type 2 diabetes. To test their hypothesis, the research team evalua Continue reading >>
Subclinical Hypothyroidism And Type 2 Diabetes: A Systematic Review And Meta-analysis
Abstract Abundant evidence suggests an association between subclinical hypothyroidism (SCH) and type 2 diabetes mellitus (T2DM), but small sample sizes and inconclusive data in the literature complicate this assertion. We measured the prevalence of SCH in T2DM population, and investigated whether T2DM increase the risk of SCH and whether SCH was associated with diabetic complications. We conducted a meta-analysis using PubMed, EMBASE, Web of Science, Wan Fang, CNKI and VIP databases for literature search. We obtained studies published between January 1, 1980 to December 1, 2014. The studies were selected to evaluate the prevalence of SCH in T2DM subjects, compare the prevalence of SCH in T2DM subjects with those non-diabetics, and investigate whether diabetic complications were more prevalent in SCH than those who were euthyroid. Fixed and random effects meta-analysis models were used, and the outcome was presented as a pooled prevalence with 95% confidence interval (95% CI) or a summary odds ratio (OR) with 95% CI. RESULTS Through literature search, 36 articles met the inclusion criteria and these articles contained a total of 61 studies. Funnel plots and Egger’s tests showed no publication bias in our studies, except for the pooled prevalence of SCH in T2DM (P = 0.08) and OR for SCH in T2DM (P = 0.04). Trim and fill method was used to correct the results and five potential missing data were replaced respectively. The adjusted pooled prevalence of SCH in T2DM patients was 10.2%, meanwhile, T2DM was associated with a 1.93-fold increase in risk of SCH (95% CI: 1.66, 2.24). Furthermore, SCH might affect the development of diabetic complications with an overall OR of 1.74 (95% CI: 1.34, 2.28) for diabetic nephropathy, 1.42 (95% CI: 1.21, 1.67) for diabetic retinopathy, 1 Continue reading >>
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Diabetes Mellitus And Primary Hypothyroidism
This Issue From 1957 to 1972, 114 cases of primary hypothyroidism were found in 60,073 patients seen at the Joslin Clinic, Boston (incidence, 0.19%). In 94 patients, the diabetes mellitus preceded the hypothyroidism. In 38% of the diabetic patients who eventually became hypothyroid, the diabetes mellitus was noted before the age of 30 years. The elapsed time between the diagnosis of the Continue reading >>
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Background
Hyperthyroidism is a condition of thyroid hyperfunction and overproduction of thyroid hormones. Autoimmune Graves' disease is the most common cause in young people, especially women, and toxic goitre or toxic adenoma are more common in older individuals. BACKGROUND In 1786 Caleb Perry made the first description of the association between goitre and exophthalmos. In 1835 Graves and in 1840 von Basedow independently described the condition associated with their names. Toxic multinodular goitre (Plummer's disease) was first described in 1913. Graves' disease accounts for nearly 60% of cases of hyperthyroidism, and occurs at a median age which is 20 years younger than patients with adenoma (about 10% of cases), and 10 years younger than multinodular goitre (30% of cases). Adenoma and multinodular goitre have a higher prevalence in iodine-deficient areas than in iodine-sufficient ones[1]. These different groups of patients have different relationship to diabetes. Diabetes is more likely to occur in hyperthyroid patients [2], and glucose intolerance is often present in untreated hyperthyroidism. Autoimmune thyroid disease also frequently occurs within type 1 diabetes (anti-TPO antibodies are present in up to 50% of insulin dependent diabetes mellitus patients) or vice versa, in the Autoimmune Polyendocrine Syndromes[3], due to overlapping HLA associations. Thyroid dysfunction does not cause type 1 diabetes, but patients with Graves' disease are more likely to develop type 1 diabetes, and vice versa. EPIDEMIOLOGY A Japanese study showed that patients on treatment for hyperthyroid Graves’ disease are almost twice as likely to develop type 2 diabetes than members of the general population, are less likely to have been overweight, and are less likely to have a family history of Continue reading >>
Thyroid Status In Diabetes Mellitus
1Department of Biochemistry, Regional Institute of Medical Sciences, Imphal, Manipur, India 2Department of Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India Citation: Bharat, Hijam D, Gangte D, Lalnunpui, Premchand, et al. (2013) Thyroid Status in Diabetes Mellitus. J Glycomics Lipidomics 3:106. doi: 10.4172/2153-0637.1000106 Copyright: © 2013 Bharat, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Glycomics & Lipidomics Abstract The study was carried out to estimate thyroid hormones (T3, T4 and TSH) level in diabetic patients and to compare it with normal controls in an attempt to find out the importance of thyroid hormone estimation in diabetic cases. Sixty cases of diabetes mellitus who attended Diabetic Clinic, RIMS during the period from October 2008 to March 2010 were taken as the cases and 30 healthy individuals were selected as control group. Serum total Tri-iodothyronine (T3), thyroxine (T4), thyroid stimulating hormone and blood sugar were estimated in the cases and controls. The study showed that diabetes was more prevalent in the age group of 51-65 years, and more in males (52%). The mean fasting blood sugar (126.17 ± 37.92 mg%) and serum TSH level (4.58 ± 2.90 mIU/L)were increased significantly (r=0.884, p>0.05) whereas serumT4 level (5.79 ± 4.39 μg/dl) was decreased significantly in diabetic cases when compared with controls. Mean T3 level of diabetic cases was higher than controls but it was insignificant. Diabetes mellitus cases with statistically significant higher TSH value have complicat Continue reading >>
Thyroid Disease And Diabetes
CLINICAL DIABETES VOL. 18 NO. 1 Winter 2000 PRACTICAL POINTERS Thyroid Disease and Diabetes By Patricia Wu, MD, FACE, FRCP Thyroid disease is common in the general population, and the prevalence increases with age. The assessment of thyroid function by modern assays is both reliable and inexpensive. Screening for thyroid dysfunction is indicated in certain high-risk groups, such as neonates and the elderly. Hypothyroidism is by far the most common thyroid disorder in the adult population and is more common in older women. It is usually autoimmune in origin, presenting as either primary atrophic hypothyroidism or Hashimoto's thyroiditis. Thyroid failure secondary to radioactive iodine therapy or thyroid surgery is also common. Rarely, pituitary or hypothalamic disorders can result in secondary hypothyroidism. Approximately 4 million people in the United States are hypothyroid and receive thyroxine replacement therapy. By contrast, hyperthyroidism is much less common, with a female-to-male ratio of 9:1. Graves' disease is the most common cause and affects primarily young adults. Toxic multi-nodular goiters tend to affect the older age-groups. Diabetic patients have a higher prevalence of thyroid disorders compared with the normal population (Table 1). Because patients with one organ-specific autoimmune disease are at risk of developing other autoimmune disorders, and thyroid disorders are more common in females, it is not surprising that up to 30% of female type 1 diabetic patients have thyroid disease. The rate of postpartum thyroiditis in diabetic patients is three times that in normal women. A number of reports have also indicated a higher than normal prevalence of thyroid disorders in type 2 diabetic patients, with hypothyroidism being the most common disorder. Table Continue reading >>
Hypothyroidism In Diabetes Mellitus Patients In Eastern Nepal
Context: The coexistence of diabetes mellitus (DM) with hypothyroidism is a known clinical observation. Aims: To estimate prevalence and co-relate that of hypothyroidism in patients with DM in relation to the age and sex, the lipid profile, body mass index visiting diabetes clinic and inpatients in B. P. Koirala Institute of Health Sciences. Settings and Design: The hospital-based descriptive study. Materials and Methods: Two hundred and seventy-one known or newly detected cases of DM aged more than 15 years were selected randomly from September 2012 to September 2013 and subjected to evaluation for thyroid function - clinically and biochemically and other relevant investigations were done. Statistical Analysis Used: For descriptive statistics mean, standard deviation, percentage, proportion were calculated. For inferential statistics following test were carried out at the level of significant 0.05 where confidence interval is 95%. The statistical operations were done through Statistical Package for the Social Sciences version 10. Results: Of 271 subjects, the prevalence of hypothyroidism (clinical and subclinical) in diabetics was, 4.05% (11/271) with females preponderance, of which 7 (30.4%) were clinically hypothyroid and 4 (17.4%) were subclinical hypothyroid. One (4.3%) patient had subclinical hyperthyroidism. The mean age at diagnosis of type 2 DM was 51-60 years. 8.69% of diabetics with primary hypothyroids were having morbid obesity. High-density lipoprotein among different thyroid status were statistically significant (P = 0.042). Conclusions: Hypothyroidism is not uncommon in diabetes, and we found body mass index, mean triglyceride and cholesterol levels were more in those diabetic patients having coexisting hypothyroidism. Figure 2: Distribution of subjects Continue reading >>
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Study Of Thyroid Dysfunction In Type Ii Diabetes Mellitus | International Journal Of Pharmaceutical Sciences And Research
Home STUDY OF THYROID DYSFUNCTION IN TYPE II DIABETES MELLITUS STUDY OF THYROID DYSFUNCTION IN TYPE II DIABETES MELLITUS STUDY OF THYROID DYSFUNCTION IN TYPE II DIABETES MELLITUS Sarguru Datchinamoorthi *, Naveena Rathanavel, Balaji Rajagopalan and R. Vanaja Department of Biochemistry, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamilnadu, India. ABSTRACT: Diabetes Mellitus (DM) has emerged as a common endocrine disorder in the world and the prevalence of thyroid dysfunction is increasing at the same time. The thyroid hormones control insulin secretion. In hypothyroidism there is a reduction in glucose-induced insulin secretion by beta cells, and during thyrotoxicosis the insulin resistance will be increased. Type 2 diabetes mellitus patients with subclinical hypothyroidism are at risk of complications like neuropathy and cardiovascular events. Hence, there is a need to detect subclinical hypothyroidism in diabetic patients.50 type II DM patients were screened for thyroid function studies viz T3, T4 & TSH. 50 age and sex matched healthy volunteers were treated as controls and the results were correlated with fasting blood glucose levels and lipid parameters. The results showed a significant difference among the controls and the patients. It may be concluded from this study that there is hypothyroidsm in DM patients. INTRODUCTION: Diabetes Mellitus (DM) has emerged as pandemic health problem in the world and it is a common endocrine disorder, which has reached 20% in urban population and 10% in rural population in India. The prevalence of thyroid dysfunction in DM is increasing alarmingly. The World Health Organization (WHO) has projected that the global prevalence of diabetes will increase to 300 million (7.8%) by 2030 1. Some of the factors like s Continue reading >>
The Relationship Between Type 2 Diabetes Mellitus And Related Thyroid Diseases
Go to: 1. Introduction The role of hyperthyroidism in diabetes was investigated in 1927, by Coller and Huggins proving the association of hyperthyroidism and worsening of diabetes. It was shown that surgical removal of parts of thyroid gland had an ameliorative effect on the restoration of glucose tolerance in hyperthyroid patients suffering from coexisting diabetes [1]. There is a deep underlying relation between diabetes mellitus and thyroid dysfunction [2]. A plethora of studies have evidenced an array of complex intertwining biochemical, genetic, and hormonal malfunctions mirroring this pathophysiological association [2, 3]. 5′ adenosine monophosphate-activated protein kinase (AMPK) is a central target for modulation of insulin sensitivity and feedback of thyroid hormones associated with appetite and energy expenditure [3]. Hypothyroidism (Hashimoto's thyroiditis) or thyroid over activity (Graves' disease) has been investigated to be associated with diabetes mellitus. A meta-analysis reported a frequency of 11% in thyroid dysfunction in the patients of diabetes mellitus [4]. Autoimmunity has been implicated to be the major cause of thyroid-dysfunction associated diabetes mellitus [5–7]. Unmanaged pro diabetes, both type 1 and type 2, may induce a “low T3 state” characterized by low serum total and free T3 levels, increase in reverse T3 (rT3) but near normal serum T4 and TSH concentrations [8]. The relation between T2DM and thyroid dysfunction has been a less explored arena which may behold answers to various facts of metabolic syndrome including atherosclerosis, hypertension, and related cardiovascular disorders. T2DM owes its pathological origin to inappropriate secretion of insulin, due to defective islet cell function or beta cell mass. Continuous consump Continue reading >>
Thyroid Disorders And Diabetes
Thyroid disorders are very common in the general U.S. population, affecting up to 27 million Americans, although half that number remains undiagnosed. It is second only to diabetes as the most common condition to affect the endocrine system — a group of glands that secrete hormones that help regulate growth, reproduction, and nutrient use by cells. As a result, it is common for an individual to be affected by both thyroid disease and diabetes. Since the thyroid gland plays a central role in the regulation of metabolism, abnormal thyroid function can have a major impact on the control of diabetes. In addition, untreated thyroid disorder can increase the risk of certain diabetic complications and can aggravate many diabetes symptoms. Luckily, abnormal thyroid function can easily be diagnosed by simple blood tests, and effective treatment is available. For all of these reasons, periodic screening for thyroid disorder should be considered in all people with diabetes. What is the thyroid? The thyroid is a butterfly-shaped gland located in the neck, just below the Adam’s apple and above the collarbone. It produces two hormones, thyroxine (T4) and triiodothyronine (T3), which enter the bloodstream and affect the metabolism of the heart, liver, muscles, and other organs. The thyroid gland operates as part of a feedback mechanism involving the hypothalamus, an area of the brain, and the pituitary gland, which is located within the brain. First, the hypothalamus sends a signal to the pituitary through a hormone called TRH (thyrotropin-releasing hormone). When the pituitary gland receives this signal, it releases TSH (thyroid-stimulating hormone) to the thyroid gland. Upon receiving TSH, the thyroid responds by producing and releasing the two thyroid hormones (T3 and T4). The Continue reading >>
Hypothyroidism And Diabetes Mellitus – A Risky Dual Gestational Endocrinopathy
Objectives. Diabetes mellitus (DM) and hypothyroidism are each associated with increased rate of pregnancy complications. However, their combined morbidity during gestation is poorly studied. Therefore, the aims of this study were to determine the prevalence of the combined morbidity of DM & hypothyroidism and whether it is associated with adverse maternal and neonatal outcome. Study design. This population based retrospective cohort study included 87,213 women who had 232,293 deliveries. All deliveries were divided into the following groups: (1) hypothyroidism & DM (n = 171); (2) hypothyroidism (n = 1502); (3) DM (n = 13,324); and (4) deliveries of women with neither endocrinopathy, who served as a control group (n = 217, 296). Results. The prevalence of DM & hypothyroidism in our population was 0.17%. In comparisons to the other study groups, women with DM & hypothyroidism had higher rates of infertility (p < 0.001), preeclampsia (p < 0.001), chronic hypertension (p < 0.001), preterm birth (p < 0.001), and cesarean deliveries (p < 0.001). In Generalized Estimating Equations (GEE) model, hypothyroidism & DM was an independent risk factor for cesarean section (OR 3.46; 95% CI 2.53–4.75) and for preeclampsia (OR 1.82; 95%CI 1.16–2.84). Conclusion. The combination of DM & hypothyroidism is rare, yet it is associated with higher rate of infertility, cesarean sections, preterm deliveries, and hypertensive disorders of pregnancy than the rest of the population. This dual endocrinological combination is an independent risk factor for preeclampsia and cesarean section. These findings suggest that these patients are at risk for perinatal complications and should be followed and delivered as high risk pregnancies. Continue reading >>
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Thyroid Disorders And Diabetes Mellitus
Mirella Hage, Mira S. Zantout, and Sami T. Azar Div i sion of Endocrinology, Department of Internal Medicine, American University of Beirut-Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon Correspondence should be addressed to S ami T. Azar, [email protected] Received 26 January 2011; Accepted 13 May 2011 Copyright 2011 Mirella Hage et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Studies have found that diabetes and thyroid disorders tend to coexist in patients. Both conditions involve a dysfunction of the endocrine system. Thyroid disorders can have a major impact on glucose control, and untreated thyroid disorders aect the management of diabetes in patients. Consequently, a systematic approach to thyroid testing in patients with diabetes is Thyroid diseases and diabetes mellitus are the two most common endocrine disorders encountered in clinical prac- tice. Diabetes and thyroid disorders have been shown to mutually inuence each other and associations between both conditions have long been reported [1, 2]. On one hand, thyroid hormones contribute to the regulation of carbohydrate metabolism and pancreatic function, and on the other hand, diabetes aects thyroid function tests to variable extents. This paper demonstrates the importance of recognition of this interdependent relationship between thyroid disease and diabetes which in turn wil l help guide clinicians on the optimal screening and management of these Thyroid disorders are widely common with variable preva- lence among the dierent populations. Data from the Whickham survey conducted in the late 1970s in the north of Continue reading >>
Correlation Between Diabetes Mellitus And Thyroid Dysfunction: Genetic Basis And Literature Review | Ekpe Lawson | Advances In Bioscience And Clinical Medicine
Correlation between Diabetes Mellitus and Thyroid Dysfunction: Genetic Basis and Literature Review Background: Co-existence of both thyroid dysfunction and diabetes mellitus is increasing in prevalence and is seen among many patients. The reason for this co-existence is not well known. Many different studies have been performed globally to ascertain this relationship. Aim: The aim of this study was to access the correlation between thyroid dysfunction and Type 1 and 2 diabetes mellitus. Method: Using internet search, a comprehensive literature review was done and words such as diabetes mellitus, thyroid, hypothyroidism, hyperthyroidism, thyroid antibodies, and thyroid problems were searched from Google scholar, Yahoo, PubMed, Medline, Web MD, and Scopus to check for various articles published on any probable link. The references of the relevant articles on this subject were also searched for further information. Results: Analyses of results of various studies from various parts of the world were considered and their prevalence was noted to access the correlation between thyroid dysfunction and diabetes mellitus. Subclinical hypothyroidism is seen as the commonest thyroid problem among female type 1diabetes. Conclusion: There is a strong relationship between thyroid dysfunction and Type 1 and 2 diabetes mellitus. KEYWORDS: Thyroid; Type 1diabetes; Antibodies; Type 2 diabetes; Dysfunction Akbar DH, Ahmed MM, Al-Mugalis J. Thyroid dysfunction and thyroid autoimmunity in Saudi Type 2 diabetes. Acta Diabetol 2006; 43(1): 14-8. Wang Chaoxun. The Relationship between Type 2 diabetes mellitus and related thyroid disease. J Diabetes Res. 2013;390534. Collar FA, Huggeri CB. Effects of hyperthyroidism upon diabetes mellitus striking improvement in diabetes mellitus from thyroidec Continue reading >>
