Abstract
Type 2 diabetes mellitus (T2DM) has an intersecting underlying pathology with thyroid dysfunction. The literature is punctuated with evidence indicating a contribution of abnormalities of thyroid hormones to type 2 DM. The most probable mechanism leading to T2DM in thyroid dysfunction could be attributed to perturbed genetic expression of a constellation of genes along with physiological aberrations leading to impaired glucose utilization and disposal in muscles, overproduction of hepatic glucose output, and enhanced absorption of splanchnic glucose. These factors contribute to insulin resistance. Insulin resistance is also associated with thyroid dysfunction. Hyper- and hypothyroidism have been associated with insulin resistance which has been reported to be the major cause of impaired glucose metabolism in T2DM. The state-of-art evidence suggests a pivotal role of insulin resistance in underlining the relation between T2DM and thyroid dysfunction. A plethora of preclinical, molecular, and clinical studies have evidenced an undeniable role of thyroid malfunctioning as a comorbid disorder of T2DM. It has been investigated that specifically designed thyroid hormone analogues can be looked upon as the potential therapeutic strategies to alleviate diabetes, obesity, and atherosclerosis. These molecules are in final stages of preclinical and clinical evaluation and may pave the way to unveil a distinct class of drugs to treat metabolic disorders.
Highlights
The role of hyperthyroidism in diabetes was investigated in 1927, by Coller and Huggins proving the association of hyperthyroidism and worsening of diabetes
Hyperthyroidism has been associated with insulin resistance which has been linked with elevated glucose turnover, increased intestinal glucose absorption, elevated hepatic glucose output, increased free fatty acid concentrations, increased fasting and or postprandial insulin an proinsulin levels, and increased peripheral glucose transport accompanied by glucose utilization [27, 34]
It is repeatedly proven that the association between thyroid dysfunction and diabetes mellitus is evident
Summary
The role of hyperthyroidism in diabetes was investigated in 1927, by Coller and Huggins proving the association of hyperthyroidism and worsening of diabetes. 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 [5,6,7]. 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. Journal of Diabetes Research uptake and upregulated hepatic glucose production, along with dyslipidaemia, which includes impaired homeostasis of fatty acids, triglycerides, and lipoproteins [10]
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