Abstract

Type 2 diabetes mellitus (T2DM) and thyroid disorders (TD) are the two most common endocrine disorders in clinical practice. They show mutually influence on each other. Unrecognized thyroid disorders may adversely affect the metabolic control and add more risk to an already predisposing type 2 diabetes mellitus. The objective of this study was to find out the association of thyroid hormone levels in patients with type 2 diabetes mellitus. This cross sectional study was conducted in the department of Biochemistry and outpatient department of Endocrinology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh (BIRDEM) General Hospital, Bangladesh from July 2014 to June 2015. A Total of 200 patients were selected by applying inclusion and exclusion criteria. Of them, 115 were type 2 diabetic subjects and 85 were non diabetic. Diabetic patients were diagnosed according to WHO criteria from their previous medical records. All patients were underwent thyroid function tests; free thyroxine (FT4), free tri-iodothyronine (FT3) and serum TSH (thyroid stimulating hormone). Presence of TD in T2DM and non-DM patients were estimated. Comparison of all demographic characteristics and biochemical parameters were done among the groups. The percentage of TD in type 2 diabetic patients was 23.5% and in non diabetic subjects was 12%. Serum FT3 and serum FT4 did not show any significant difference among the groups. Type 2 diabetic patients with thyroid disorders had more elevated level of serum TSH level than those who were non diabetic subjects with TD. Thyroid disorders were significantly higher in female, overweight and obese subjects. Patients with TD had strong association with family history of TD. This study showed that the presence of TD in type 2 diabetes mellitus was very high. Regular screening for thyroid disorders in type 2 diabetic patients specially serum TSH level is recommended.

Highlights

  • Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia either defect in insulin secretion or insulin action or both

  • No significant difference was to be found among the groups (p> 0.05)

  • Jain et al found that most patients with Type 2 diabetes mellitus (T2DM) with thyroid disorders (TD) had body mass index (BMI) more than 30.15 in T2DM, 70.5% thyroid patients were overweight and obese.[13]

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Summary

Introduction

Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia either defect in insulin secretion or insulin action or both. It may present different micro and macro vascular complications such as coronary artery disease, cerebrovascular disease, retinopathy, neuropathy, nephropathy etc. DM is becoming pandemic in developing countries Magnitude of this disease in Bangladesh is increasing. Bangladesh is one of the top 10 countries estimated to have the highest numbers of people with DM.[3] In Bangladesh a recent meta-analysis showed, prevalence of DM increased substantially, from 4% in 1995 to 2000 and 5% from 2001 to 2005 and 9% from 2006 to 2010.4 The prevalence of DM in Bangladesh was estimated 6.34%.2

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