Abstract
ObjectiveTo present a case report of recurrent hypoglycaemia in type 2 diabetic patient due to hypothyroidism.MethodsWe describe a case with type 2 diabetes who complained of episodes of recurrent hypoglycaemia in last few weeks. We also discuss the results of the diagnostic workup done to find out the cause of recurrent hypoglycaemia.ResultAfter ruling out common causes like overdosing of oral hypoglycaemic agents or insulin, renal or hepatic impairment we found overt hypothyroidism as a cause of recurrent hypoglycaemia. Levothyroxine therapy was started in this patient. Upon normalization of thyroid function, patient did not further experience any episodes of hypoglycaemia. We did not find any report on hypothyroidism as a cause of recurrent hypoglycaemia in type 2 diabetic patients.ConclusionWe conclude that during workup, clinicians should take hypothyroidism into consideration as a potential cause of hypoglycaemia in type 2 diabetic patients.
Highlights
Hypoglycaemia is a common condition in diabetic patients
Prevalence of hypoglycaemia has been observed in 12% of patients on diet alone followed by 16% and 30% in patients treated with oral hypoglycaemic agents and insulin respectively [1]
No significant change was noticed in the parameters during his past follow up visits. His latest retinal examination in January 2013 showed no evidence of diabetic retinopathy. Based on his blood glucose monitoring, doses of insulin glulisine were reduced to 4 units before each meal and to 6 unit of insulin glargine once daily
Summary
Hypoglycaemia is a common condition in diabetic patients. Prevalence of hypoglycaemia has been observed in 12% of patients on diet alone followed by 16% and 30% in patients treated with oral hypoglycaemic agents and insulin respectively [1]. His latest retinal examination in January 2013 showed no evidence of diabetic retinopathy Based on his blood glucose monitoring, doses of insulin glulisine were reduced to 4 units before each meal and to 6 unit of insulin glargine once daily. Diagnosis of overt hypothyroidism was made and patient started levothyroxine therapy Six weeks later his thyroid function normalized. After normalization of thyroid function patient did not experience any episode of hypoglycaemia, based on his self glucose monitoring values, insulin doses were again increased to the same doses that patient was taking earlier. Upon normalisation of thyroid function in the last one month and later during subsequent follow up clinic visits for six months patient did not report any episodes of hypoglycaemia. We did not find any report on hypothyroidism as a cause of recurrent hypoglycaemia in type 2 diabetic patients
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