DOI: http://dx.doi.org/10.18203/2349-3933.ijam20173677

Study of thyroid dysfunction in patients with type 1 diabetes mellitus

Rajesh V. Gosavi, Bhushan R. Mishal

Abstract


Background: The association of autoimmune thyroid disease with type 1 diabetes mellitus has been well documented across populations, with it being most prevalent immunological disease in patients with type 1 diabetes. The aim of this study was to ascertain the association between type 1 diabetes and thyroid dysfunction clinically, biochemically and immunologically.

Methods: Serum TSH, free T3 and free T4 values were compared between cases of type 1 diabetes mellitus and non-diabetic age and sex matched controls. Cases of type 1 diabetes mellitus were further divided in two groups, depending upon the presence or absence of antibodies against thyroid peroxidase (Anti-TPO antibodies). Mean serum TSH, free T3, free T4 levels were compared between these two groups to find or refute any association.

Results: Abnormal thyroid function was reported in total 6 (14.63%) cases. Comparison of TSH, T3 and T4 levels showed statistically insignificant differences (p<0.05) in TSH levels (µIU/ml) (Cases- 3.44±2.41, controls- 3.34±0.78); T3 levels (pg/ml) (cases- 3.31±1.06, controls- 3.36±0.52) and T4 levels (ng/dl) (cases- 0.92±0.31, controls- 0.95±0.23). Total of 6 cases (14.63%) cases of type 1 diabetes mellitus were positive for anti-TPO antibodies (4- females, 2- males).

Conclusions: Thyroid dysfunction is more common amongst type 1 diabetics, especially females. Estimation of anti-TPO antibodies is valuable in detecting thyroid dysfunction in type 1 diabetics.


Keywords


Thyroid dysfunction, Type 1 diabetes mellitus

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References


Wang C, Crapo LM. The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin North Am. 1997;26:189-218.

Bottazzo GF, Mann JI, Thorogood M, Baum JD, Donaich D. Autoimmunity in juvenile diabetes and their families. Br Med J. 1978:2:165-8.

Riley W, Maclaren N, Zlezotte D, Spiller R, Rosenbloom A. Thyroid autoimmunity in insulin-dependent diabetes mellitus: the case for routine screening. J Pediater. 1981;98:350-4.

Riley W, Winer A, Goldstein D. Coincident presence of thyroid gastric autoimmunity at onset of type 1 (insulin-dependent) diabetes. Diabetol. 1983;24:418-21.

Betterle C, Zanette F, Pedini B, Presetto F, Rapp LB, Monciotti CM, et al. Clinical and subclinical organ-specific autoimmune manifestations in type 1 (insulin-dependent) diabetes patients and their first-degree relatives. Diabetol. 1984;26:431-6.

Chikuba N, Akazawa S, Yamaguchi Y, Kawasaki E, Takino H, Takao Y, et al. Type 1 diabetes mellitus with coexisting autoimmune thyroid disease in Japan. Int Med. 1992;31:1076-80.

Tsai WY, Lee JS. Thyroid disease in Chinese children with type 1 diabetes mellitus. Diabet Care. 1993;16:1314-5.

Patricia WU. Thyroid diseases and diabetes. Clin Diabet. 2001;18(1):38.

Satish R, Mohan V. Diabetes and thyroid disease: a review. Int J Diab Dev Countries. 2003;23;120-3.

American Diabetes Association: Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33:562-9.

Pasupathi P, Bakthavatsalam G, Saravanan G, Sundarmoorthy R. Screening for thyroid dysfunction in diabetic/nondiabetic population. Thyroid Sci. 2008;3(8):1-6.

Perros P, McCrimmon RJ, Shaw G, Frier BM. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diab Med. 1995;12:622-7.

Shiva S, Afshin G, Behbahan. Autoimmune thyroid disease in children and adolescents with type 1 diabetes mellitus in northwest Iran. Saudi Med J. 2009;30(5):673-76.

Sahasrabuddhe A, Pitale S, Sagdeo M, Gade S. Study of thyroid functions in patients with type-1 diabetes. Vid J Intern Med. 2011;11:21-6.

De Greef WJ, Rondeel JM, Van Haasteren GA, Klootwij KW, Visser TJ. Regulation of TRH production and release in rats. Acta Medica Austriaca. 1992;19(1):77-9.

Mccanalies E, O’Leary LA, Foley TP. Hashimoto’s thyroiditis and insulin dependent diabetes mellitus: differences among individuals with and without abnormal thyroid function. J Clin Endocrinol Metab. 1998;83:1548-51.

Dorman JS, Steenkiste AR, Burke JP. Type 1 diabetes and multiple sclerosis: together at last. Diabetes Care. 2003;26:3192-3.

Meloni GF, Tomasi PA, Bertoncelli A, Fanciulli G, Dellitala G, Meloni T. Prevalence of silent celiac disease in patients with autoimmune thyroiditis from Northern Sardinia. J Endocrinol Invest. 2001;24:298-302.

Goswami R, Marwaha RK, Goswami D, Gupta N, Ray D, Tomar N. Pravalene of thyroid autoimmunity in sporadic idiopathic hypoparathyroidism in comparison to type 1 diabetes and premature ovarian failure. J Clin Endocrinol Metab. 2006;91:4256-9.

Unnikrishnan AG, Kumaravel V, Nair V, Rao A, Jayakumar RV, Kumar H, et al. TSH receptor antibodies in subjects with type 1 diabetes mellitus. Ann N Y Acad Sci. 2006;1079:220-5.

Franzese A, Buono P, Mascolo M. Thyroid autoimmunity starting during the course of type 1 diabetes denotes a subgroup of children with more severe diabetes. Diabetes Care. 2000;23:1201-12.

Krishna CS, Vibha C, Manohar CS, Anil Kumar GS, Nanda K, Sadanand G. Thyroid dysfunction in type 1 diabetes. IJBMS. 2011;2(4):212-8.

Ardestani SK. Thyroid disorder in Type 1 Diabetes mellitus in children. Iran J Pediatr. 2011;21(4):502-8.