Thyroid Dysfunction In Diabetic Patients Research Articles

Study of correlation of hypothyroidism with diabetic microvascular complications in type 2 diabetic adult Indian females

Background: Patients with type 2 diabetes mellitus are more prone to thyroid disorders. Hypothyroidism in them leads to an aggravation of microvascular complications. Screening for thyroid dysfunction in diabetic patients will allow early treatment of hypothyroidism. The aim of this study is to assess the correlation of hypothyroidism with diabetic microvascular complications. Methods: This is a cross‑sectional study that was conducted at department of medicine GSVM Medical College, Kanpur. 200 female patients with type 2 diabetes mellitus attending the out‑patient department were included. Subjects with any prior history of thyroid disease, chronic liver disease, or acute illness were excluded from the study. Results: Our study describes 14% prevalence of hypothyroidism (subclinical hypothyroidism 13.5%) among 200 diabetic subjects. Among hypothyroid patients 64.29% patients had nephropathy, 60.71% patients had neuropathy, 64.29% patients had retinopathy whereas euthyroid patients had 26.74%, 25% and 29.07% nephropathy, neuropathy, and retinopathy respectively. Conclusions: The prevalence of hypothyroidism was 14% among female patients with type 2 diabetes mellitus in this study. Overt hypothyroidism was 0.5 % and subclinical hypothyroidism was more common (13.5%) among the study subjects. Patients having hypothyroidism were more likely to be having diabetic nephropathy, neuropathy, and retinopathy.

Frequency of Thyroid Dysfunction in Diabetic Patients

Thyroid hormones are involved in the control of insulin secretion, beta-cell function/multiplication, liver glucose synthesis, output and peripheral utilization. Thyroid dysfunction identification and correction help in glycemic control. Objective: To know the frequency of thyroid dysfunction in diabetic patients. Methods: This descriptive cross-sectional study was done in the Medical-C Department, Ayub Teaching Hospital Abbottabad from July 2018 to August 2019. Total 150 diabetic patients were enrolled by using non-probability consective sampling. Patients were labelled as diabetics on the basis of diabetes history, anti-diabetic medications use, high blood glucose (>200mg/dl) on presentation or on previous high blood sugar reading or a high HbA1c value. Fresh venous blood sample was sent for thyroid function tests (T3, T4 and TSH). Thyroid dysfunction in our study was defined as patient having Thyroid Stimulating Hormone (TSH) value above or below the normal range. Data of patients were collected on study pro forma and was analyzed using statistical program SPSS version-20.0 Results: There were 67 (44.66%) male and 83 (55.33%) female patients. The mean age was 51.83 ± 14.52 years. Thyroid dysfunction was detected in 37 (24.66%) study participants. Out of 67 male patients, 11 (16.41%) had thyroid dysfunction and out of 83 female patients, 26 (31.32%) had thyroid dysfunction. Subclinical hypothyroidism was present in 4 (2.7%), 5 (3.3%) had hypothyroidism, 20 (13.3%) had subclinical hyperthyroidism and 8 (5.3%) had hyperthyroidism. Conclusion: This study suggests that a significant portion of diabetic patients suffer from thyroid dysfunction.

Thyroid dysfunction in type 2 diabetes mellitus patients attending diabetic clinic in a tertiary care centre: a cross-sectional study

Background: Thyroid disease and type 2 diabetes mellitus are two common co-existing endocrinopathies found in the general population. Since thyroid dysfunction complicates the metabolic derangement observed in diabetes, its treatment is necessary in order to achieve stability of metabolic control. Therefore, the aim of the present investigation was to estimate the functional thyroid disorders and the associated factors in type 2 diabetes patients.Methods: In 230 diabetic patients, the blood sugar level and thyroid function tests were performed and compared. Most of the patients were in the age group of 51-60 years (36.08%).Results: The prevalence of thyroid dysfunction in diabetic patients was 15.21% with a higher rate in female patients. Subclinical hypothyroidism (12.17%) was the commonest thyroid dysfunction.Conclusions: The data suggest that subclinical hypothyroidism was more prevalent in type 2 diabetes mellitus, and may confer a greater risk of diabetic complications. It is therefore important to diagnose thyroid dysfunction in diabetic patients and the practice should be inculcated in diabetic care.

Association of Hypothyroidism With Type 2 Diabetes Mellitus: A Hospital Based Experience in a Tertiary Care Centre

Background:Thyroid diseases and diabetes mellitus are the two most common endocrine disorders encountered in clinical practice. Type 2 diabetes mellitus (T2DM) has an intersecting underlying pathology with thyroid dysfunction. Insulin and thyroid hormones are intimately involved in cellular metabolism and thus excess or deficit of either of these hormones result in the functional derangement of the other.Despite the absence of definite guidelines regarding screening for thyroid dysfunction in diabetic patients, in the view of this incidence together with the mutual effect of the common two endocrinopathies on each other and the increased risk of complications in diabetic patients in the setting of abnormal thyroid dysfunction, a systematic approach to thyroid testing in diabetic patients is favorable. Methods:A Cross sectional descriptive observational study was performed at a tertiary care centre.Patients of 30 years and older with known type 2 DM without thyroid disorders between March 2018 to September 2018 were included in this study by purposive sampling technique.A total of 100 patients were included in the study. Results:Among the study patients, 13(26%) had thyroid abnormalities, 8 cases were male and 5 cases were female. Thyroid abnormality was associated with duration of DM. The mean duration of disease was 6.28±2.57 years in patients with normal thyroid profile group and 10.92±8.13 years in patients with abnormal thyroid profile (hypothyroidism or hyperthyroidism) group. Patients with poor glycemic control prone to develop endocrinopathies like thyroid abnormality. HbA1c also shows the positive correlation with thyroid abnormality in type 2 diabetes patients. Regarding the definition of thyroid abnormality, 7% patients had Primary hypothyroidism, 2% Subclinical hypothyroidism and 3% primary hyperthyroidism and single case subclinical hyperthyroidism. Conclusion: Our results demonstrate that hypothyroidism is the common thyroid disorder in type 2 DM patient. It seems that unidentified thyroid dysfunction could positively impact diabetes and its complications. The ability to diagnose and treat unsuspected thyroid dysfunction in these patients may greatly enhance the quality of life. Hence the need to detect such cases where thyroid dysfunction contributes to morbidity and where it is the cause for poor control of the associated conditions. Bangladesh J Medicine 2022; 33: 193-201

The incidence of thyroid dysfunction in diabetic patients – A study done at a tertiary care center in South India

It has been noted that in the Indian population the incidence of thyroid disorder is common and its incidence rises with advancing age. Screening for thyroid disorder is indicated for the certain high risk patients such as elderly and those already having other endocrinal disorders There are various studies that have shown a finding that a higher than normal prevalence of thyroid disorders in type 2 diabetic patients, of which hypothyroidism is the commonest disorder Owing to this we at the medical college at south India decided to evaluate the occurrence of thyroid dysfunction in patients who have been diagnosed with diabetes mellitus and also to compare the level of thyroid dysfunction in the younger and the older population.Department of surgery, medicine and Pharmacology at Al Azhar Medical College Thodupuzha, Kerala, India for a duration of 3 years on 300 patients. The present study was an observational study during the period of study, the test subjects patients having diabetes mellitus and healthy individuals (Controls)coming for regular health check-up with no co morbidities detected were included in this study as controls.In the non -geriatric age group the mean age was 49.6 years SD + 8.15 years and in the geriatric age group the mean age was 68.78 years SD + 4.83 years. The commonest age group in the study was between the age of 61-70 years with of the study population. The age group in the present study ranged between the age of 30 years and 79 years. The incidence of diabetes mellitus increased with age, but the control of sugars is better with age thyroid dysfunction was as follows 20% had hyperthyroidism (36%) hypothyroidism. There is a linear increase with the prevalence of thyroid disorders with age with a r= 0.77 and p < 0.05.The incidence of thyroid dysfunction also increased with age As compared to the non -geriatric group which was the incidence higher in older age group p < 0.05.This study reveals about at least one in three who have DM are suffering from thyroid dysfunction, that increases with increasing age and uncontrolled sugars in this part of the world, which might warrant routine screening.

The Frequency of Thyroid Dysfunctions among Patients of Diabetes Mellitus Presenting in Tertiary Care Hospital of a Developing Country

Aims: Thyroid disease is a pathological state associated significantly with diabetes mellitus (DM) Type 1 and Type 2. As the prevalence of diabetes mellitus is on the rise in our population, so the purposed significance of our study was to evaluate the frequency of thyroid dysfunction in diabetic patients of our local population.
 Study Design: Cross-sectional study.
 Place and Duration of Study: This study conducted among patients of diabetes (Type 1 and Type 2) from September 2020 to March 2021 while their visit in Holy family hospital, Rawalpindi, for a routine clinical check-up on an OPD basis.
 Methodology: A total of 96 patients with diabetes mellitus on regular medication, 20 to 60 years of age, were included. Patients with diabetic ketoacidosis, hyperlipidemia, pregnant females, and those taking medication that can affect thyroid functions (dopamine antagonists, antiepileptics, oral contraceptives, lithium, glucocorticoids) were excluded. A venous blood sample was drawn and sent to the laboratory to analyze thyroid function tests for the presence or absence of any thyroid dysfunction. Data analysis was done through SPSS.v.23. Descriptive statistics and Chi-square analysis was used, and a p-value of ≤ 0.05 was considered significant.
 Results: The mean age of the patients was 42.97 ± 10.29 years. The majority of the patients, 37.50%, were between 41 to 50 years of age. Out of 96 patients, 61 (63.54%) were male, and 35 (36.46%) were females with a male to female ratio of 1.7:1. The majority of patients, 69 (71.88%), had type II diabetes mellitus. The frequency of thyroid dysfunction found in diabetic patients was 30 (31.25%), with hypothyroidism in 19 (19.79%) and hyperthyroidism in 11 (11.46%) patients.
 Conclusion: This study deduced that there is a high frequency of thyroid dysfunction in diabetic patients. In the same vein, hypothyroidism was the common thyroid dysfunction associated with diabetes mellitus.

PREVALENCE OF THYROID DYSFUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Background: Patients with type 2 diabetes mellitus are more prone to thyroid disorders. Hypothyroidism in them leads to an aggravation of microvascular complications. Diabetic patients with hypothyroidism also are at an increased risk of cardiovascular disease. Screening for thyroid dysfunction in diabetic patients will allow early treatment of hypothyroidism.
 Methods: All patients were evaluated for thyroid status; assessment of T3, T4 and TSH levels and Blood glucose levels and HbA1c.
 Results: 22.00% patients were present with subclinical hypothyroidism, 18.00% patients were present with hypothyroidism and 4.00% patients present with hyperthyroidism
 Conclusion: Screening for thyroid disease disease among patients with diabetes mellitus should be routinely performed for early detection and treatment of thyroid dysfunction to delay the complications of diabetes
 Keywords: Thyroid, Type-2DM, Complication

Evaluation of thyroid function in diabetes mellitus at a tertiary care hospital in central Karnataka

Background: The thyroid hormone abnormalities are closely associated with diabetes. Undetected, untreated thyroid dysfunction may impair diabetes control, its early detection. Hence, prompt treatment among diabetics would be beneficial in achieving glycemic control, minimizing cardiovascular risk and improving general well‑being. In this central Karnataka As the data on thyroid disorders in diabetics is limited region, the present study was taken up to estimate the thyroid dysfunction in diabetic patients. Aim: To estimate the thyroid dysfunction in diabetic patients. Material and Methods: Hospital-based cross-sectional study was conducted after obtaining institutional ethics committee clearance, at a tertiary care teaching hospital in Chitradurga, Karnataka, among 100 diagnosed cases of diabetes mellitus. Patients’ lipid, thyroid and diabetic profiles were estimated and were then divided as hypothyroid, hyperthyroid, and euthyroid depending on the thyroid profiles. Results: Out of 100 diabetic patients, 71% were euthyroid, 23% hypothyroid and 6% were hyperthyroid. BMI, waist: hip ratio, TSH were significantly lower (22.3±1.8 Kg/mt2; 0.79±0.18), whereas T3 and T4 were significantly elevated among hyperthyroid patients compared to hypothyroid and euthyroid group. Levels of FBS, total cholesterol, triglycerides, LDL cholesterol and HbA1c were significantly elevated in hypothyroid patients. The mean levels of FBS, total cholesterol, triglycerides, LDL cholesterol and HbA1c were significantly elevated in hypothyroid patients compared to euthyroid group. Conclusion: Unidentified thyroid dysfunction could negatively impact diabetes and its complications and may be one of the prime causes of poor management of type 2 DM. Therefore, there is a need for routine assay of thyroid hormones in type 2 diabetic patients to improve the medical management as well as to reduce the morbidity in them.

Thyroid dysfunction in patients with type 2 diabetes mellitus and its association with diabetic complications.

Background and Aims:Patients with type 2 diabetes mellitus are more prone to thyroid disorders. Hypothyroidism in them leads to an aggravation of microvascular complications. Diabetic patients with hypothyroidism also are at an increased risk of cardiovascular disease. Screening for thyroid dysfunction in diabetic patients will allow early treatment of hypothyroidism. The aim of this study was to assess the level of thyroid dysfunction in patients with type 2 diabetes mellitus and to identify the association of thyroid dysfunction with diabetic complications.Methods:This is a cross-sectional study that was conducted at departments of Medicine & Endocrinology in JIPMER, Pondicherry, between June 2016 and May 2019. 331 patients with type 2 diabetes mellitus attending the out-patient department without any prior history of thyroid disease, chronic liver disease or acute illness were recruited for the study. All subjects were screened for diabetic complications (nephropathy, neuropathy, retinopathy & cardiovascular disease). Thyroid function test was done in all subjects using chemiluminescent immunoassay method.Results:Hypothyroidism was seen in 13.9%, while hyperthyroidism was observed in 3.6% of the study subjects. Thyroid dysfunction was more common among females than males. No correlation was seen between thyroid dysfunction and diabetic complications in the study subjects.Conclusion:The prevalence of thyroid dysfunction is 17.5% in patients with type 2 diabetes mellitus. Thyroid dysfunction did not have any correlation with diabetic complications.

The prevalence and incidence of thyroid dysfunction in patients with diabetes - a longitudinal follow-up study

Thyroid dysfunction (TD) occurs in 13.4% of diabetic patients, which has prompted recommendations for annual thyroid screening in patients with diabetes. However, recommendations for annual screening should be based on disease incidence rather than prevalence. In 1997-1998, seven hundred and thirty patients (618 type 2 diabetes, 55% male; 112 type 1 diabetes, 47% male) were sequentially screened for TD. The 639 patients with normal thyroid function were followed from 1999 to 2006, with annual thyroid function tests. A total of 21/112 (19%) with type 1 diabetes (T1DM) and 70/618 (11%) with type 2 diabetes (T2DM) had TD. TD was more frequent in females (p < 0.05) and T1DM (p = 0.04). The mean annual rate of conversion to abnormal tests was 2.1%. At 8years, there were 100 new cases of TD representing 15.6% of the cohort (17 T1DM and 83 T2DM). TD was more frequent in females (p < 0.05), but there was no difference in the incidence of new TD between T1DM and T2DM (p = 0.39). Our data confirms the high prevalence of TD in diabetic patients, in concordance with the results from other series. We found only 25 treatable cases of new thyroid disease from 639 patients in the 8-year follow-up, less than 0.5% per year. The low incidence of treatable thyroid disease challenges the need for annual screening for thyroid abnormalities in patients with type 2 diabetes.

Thyroid dysfunction prevalence and relation to glycemic control in patients with type 2 diabetes mellitus

ObjectiveIt is usually difficult to clinically identify thyroid abnormalities in diabetics as features of thyroid dysfunction may simulate diabetes symptoms or complications. So, assessing thyroid dysfunction prevalence in patients with type 2 diabetes mellitus (DM) would help better control of DM and its complications. Several studies reported this prevalence, however, some included small sample size or lacked a control group. We aimed to determine thyroid dysfunction prevalence in diabetic patients as well as its relation to glycemic control. MethodsA cross-sectional study included 200 patients having type 2 DM and 200 apparently healthy controls. Each participant was tested for fasting and 2-h post-prandial blood glucose, glycated haemoglobin (HbA1C), thyroid function tests: thyroid-stimulating hormone (TSH), free tri-iodothyronine (FT3), free thyroxine (FT4), serum total cholesterol and triglycerides and thyroid antibodies; anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) for hypothyroidism only. ResultsThere was a significant increase in serum TSH and T3 levels in diabetics when compared with the controls, (P < 0.001, P = 0.001), respectively. Thyroid dysfunction was significantly more prevalent in patients with HbA1c ≥ 8%, (P = 0.0001), and in those having longer diabetes duration, (P < 0.001). ConclusionThere was a higher prevalence of thyroid dysfunction among patients with type 2 DM. This dysfunction increased with the rise of HbA1c. This could suggest that poor glycemic control may have a role in the development of thyroid dysfunction in type 2 DM patients. Subclinical hypothyroidism was the most prevalent type of thyroid dysfunction in diabetic patients.

Correlation Between Glycosylated Haemoglobin and Thyroid Function Tests in Patients with Type-2 Diabetes Mellitus

ABSTRACT: OBJECTIVES: The aims of this study were to determine the frequency of undetected dysfunction of thyroid in patients with diabetes, determination of correlation between glycosylated Hb and thyroid hormones, and to find out the relationship between blood glucose control and function of thyroid in patients of type 2 diabetes mellitus in comparison to normal individuals. METHODOLOGY:This study was carried out at Department of Medicine, Hayatabad Medical Complex, Peshawar. It was a cross sectional study. A sample size of 358 subjects was taken using non-probability consecutive sampling in which 179 had type-2 diabetes and 179 were healthy normal subjects. Based on the results, they were classified into either hypothyroid or hyper thyroid categories, and then a comparison was done with HbA1c to determine their correlation. The data was analyzed by using SPSS version 23. RESULTS: The mean age of both the groups was 54.35 ± 9.38 years and 42.66 ± 9.20 years respectively on comparison of median (as data lacked normality) and mean ages of cases was much higher as while drawing comparison to control group with p-value less than 0.001. In these cases, the total number of male patients were 62 (34.64%) and females were 117 (65.36%) while in controls the males and females were 124 (69.27%) and 55 (30.73%) respectively. In these cases, the number of hypothyroid patients were 13 (7.3%), hyperthyroid individuals were 26 (14.5%) and 11(6.1%) cases had subclinical hyperthyroidism. Normal thyroid function was found in all controls. In these cases, a weak positive correlation was found between HBA1c and T3 (r=0.239, p-value 0.001). Also, there was an insignificant correlation with T4 (r= - 0.017, p-value = 0.817) and correlation of insignificant nature found with TSH (r= -0.036, p-value = 0.634). Among controls same (insignificant) correlation was found between Glycosylated Hb and T3 (r= 0.070 p-value = 0.352), a weak positive correlation with T4 (r= 0.238, p-value = 0.001) and a moderate negative relationship with thyroid stimulating hormone (r= - 0.586, p-value &lt;0.001). CONCLUSION: Early detection of thyroid dysfunction in diabetic patients can prevent complications and leads to optimum control of blood glucose level.

Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders.

Thyroid dysfunction and diabetes mellitus are closely linked. Several studies have documented the increased prevalence of thyroid disorders in patients with diabetes mellitus and vice versa. This review critically discusses the different underlying mechanisms linking type 1 and 2 diabetes and thyroid dysfunction to demonstrate that the association of these two common disorders is unlikely a simple coincidence. We assess the current state of knowledge on the central and peripheral control of thyroid hormone on food intake and glucose and lipid metabolism in target tissues (such as liver, white and brown adipose tissue, pancreatic β cells, and skeletal muscle) to explain the mechanism linking overt and subclinical hypothyroidism to type 2 diabetes and metabolic syndrome. We also elucidate the common susceptibility genes and the pathogenetic mechanisms contributing to the autoimmune mechanism involved in the onset of type 1 diabetes mellitus and autoimmune thyroid disorders. An untreated thyroid dysfunction can impair the metabolic control of diabetic patients, and this association can have important repercussions on the outcome of both of these disorders. Therefore, we offer recommendations for the diagnosis, management, and screening of thyroid disorders in patients with diabetes mellitus, including the treatment of diabetic patients planning a pregnancy. We also discuss the major causes of failure to achieve an optimal management of thyroid dysfunction in diabetic patients and provide recommendations for assessing and treating these disorders during therapy with antidiabetic drugs. An algorithm for a correct approach of these disorders when linked is also provided.

Prevalence of Thyroid Dysfunction in Diabetic Patients of Visakhapatnam District

Prevalence of Thyroid Dysfunction in Diabetic Patients of Visakhapatnam District

Prevalence of Thyroid Dysfunction in Diabetic Patients

Prevalence of Thyroid Dysfunction in Diabetic Patients

Subclinical hypothyroidism ups the risk of vascular complications in type 2 diabetes

The incidence of thyroid dysfunction in diabetic patients is higher than that of the general population. Undiagnosed thyroid dysfunction may affect the metabolic control and enhance cardiovascular, and other chronic complication risks in diabetic patients. Few studies have examined the relationship between subclinical hypothyroidism (SCH) and vascular complications of type 2 diabetes. Objectives: To find out the relationship between SCH and vascular complications in patients with Type 2 diabetes. Subjects and Methods: Our cross sectional study included 110 patients with type 2DM (45 males and 65 females) who were followed at the Diabetes outpatient Clinics in the state of Kuwait during 6months period. All patients subjected to complete clinical and laboratory data, including thyroid function tests, total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, urinary albumin, fundus examination, ECG, and Glycosylated hemoglobin. Results: Among 110 patients, 21 (19.1%) Patients had SCH. Patients with SCH were more significantly older, with longer duration of diabetes, higher HbA1c, total cholesterol and LDL-C than euthyroid group. However, gender (p=0.076), BMI (p=0.092), and smoking (P=0.715) were not significantly different between the SCH and euthyroid groups. The SCH group had a higher prevalence of dyslipidemia (p=0.017), diabetic nephropathy (p=0.003) diabetic retinopathy (p=0.004) and IHD (p=0.011) than the euthyroid group while no significant difference in the prevalence of diabetic neuropathy (p=0.420). Conclusions: SCH is a common endocrine disorder in patients with Type 2 diabetes. It could be associated with a higher prevalence of vascular complications in type 2 diabetes. We could not prove a relation between SCH and diabetic neuropathy.

Original Article: Study of Thyroid Dysfunction in Diabetic Patients

Original Article: Study of Thyroid Dysfunction in Diabetic Patients

Thyroid dysfunction in patients with diabetes: clinical implications and screening strategies

Patients with diabetes mellitus are at an increased risk of thyroid disease. The frequency of thyroid dysfunction in diabetic patients is higher than that of the general population and up to a third of patients with type-1 diabetes (T1DM) ultimately develop thyroid dysfunction. Unrecognised thyroid dysfunction may impair metabolic control and add to cardiovascular disease risk in diabetic patients. Our aims were to review the current literature on the association between thyroid dysfunction and diabetes mellitus, to highlight relevant clinical implications, and to examine present thyroid disease screening strategies in routine diabetes care. The pleiotropic effects of thyroid hormones on various metabolic processes are now better understood. Uncontrolled hyperthyroidism in diabetic patients may trigger hyperglycaemic emergencies while recurrent hypoglycaemic episodes have been reported in diabetic patients with hypothyroidism. Furthermore, thyroid dysfunction may amplify cardiovascular disease risk in diabetic patients through inter-relationships with dyslipidaemia, insulin resistance and vascular endothelial dysfunction. However, the significance of subclinical degrees of thyroid dysfunction remains to be clarified. While these developments have implications for diabetic patients a consensus is yet to be reached on optimal thyroid screening strategies in diabetes management. The increased frequency of thyroid dysfunction in diabetic patients and its likely deleterious effects on cardiovascular and metabolic function calls for a systematic approach to thyroid disease screening in diabetes. Routine annual thyroid testing should be targeted at diabetic patients at risk of thyroid dysfunction such as patients with T1DM, positive thyroid autoantibodies or high-normal TSH concentrations.

TSH and TPOAB as Predictors of Thyroid Disease in Diabetic Patients

Abstract: We tested the values of antithyroid peroxidase antibody and thyrotropin levels for the development of thyroid dysfunction in 109 diabetic patients. Baseline thyrotropin level was a predictor of thyroid dysfunction in diabetic patients, excluding nodular disease. The antithyroid peroxidase antibody had no predictive value for thyroid dysfunction.