Abstract
PurposeTo observe the glycemic variation (GV) in uncontrolled Graves’ disease (GD) patients with normal glucose metabolism measured by continuous glucose monitoring (CGM).MethodsThis was a single-center, open-label, observational study. From January 2017 to October 2017, 20 GD patients with normal glucose metabolism and 24 healthy control subjects were recruited. Serum samples were obtained at 0, 30, and 120 min after oral glucose loading for glucose, insulin, and C-peptide level measurements. Fasting plasma fasting free triiodothyronine (FT3), free thyroxin (FT4), and thyroid stimulating hormone concentrations were also detected. All participants were subjected to a 3-day CGM after baseline data were collected. The primary endpoint was the difference in the mean amplitude of the glycemic excursions between the two groups.ResultsCompared with the healthy subjects, the GD patients had higher mean amplitude of glycemic excursions (MAGE) (P < 0.01). Multiple linear stepwise regression analysis showed that FT4 level was an independent factor for the MAGE. Interestingly, the GD patients had a significant prolongation in the time to peak glucose, especially after breakfast (P < 0.01), and the elevation in the incremental area under the curve of glucose after breakfast till 4 hours later.ConclusionsUncontrolled GD patients with normal glucose metabolism had a greater GV, and the FT4 level may contributed to the increased GV.
Highlights
Impaired glucose tolerance, insulin resistance, and increased insulin secretion were found in patients with hyperthyroidism [1–5]
Studies demonstrated that Graves’ disease (GD) patients with type 2 diabetes (T2D) had increased fasting and postprandial blood glucose monitored by Continuous glucose monitoring (CGM), and the glucose profile was improved along with the normalization of thyroid function [12], which indicated that the thyroid
Between January 2017 and October 2017, a total of 33 GD patients and 44 healthy control subjects were recruited for the study
Summary
Insulin resistance, and increased insulin secretion were found in patients with hyperthyroidism [1–5]. Continuous glucose monitoring (CGM) provides 288 glucose signals throughout a period of 24 hrs. Studies demonstrated that GD patients with type 2 diabetes (T2D) had increased fasting and postprandial blood glucose monitored by CGM, and the glucose profile was improved along with the normalization of thyroid function [12], which indicated that the thyroid. Endocrine (2019) 64:265–270 function might be a risk factor of GV. The GV in GD patients with a normal glucose metabolism was not well clarified perhaps because of scarcity of studies using CGM. We compared the 24 hrs GVs using CGM between GD patients with normal glucose tolerance (NGT) and healthy control subjects
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