Thyroid dysfunction in type 2 diabetes mellitus patients attending diabetic clinic in a tertiary care centre: a cross-sectional study
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20222139Keywords:
Type 2 diabetes, Hyperthyroidism, Hypothyroidism, OPDAbstract
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.
Metrics
References
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison’s principles of internal medicine. 19th ed. USA: Mcgraw-hill; 2015:1;145-9.
Alberti KGMM, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med. 1998;15(7):539-53.
Zimmet P, Alberti K, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001; 414(6865):782-7.
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diab Care. 2004;27(5): 1047-53.
Ramachandran A, Snehalatha C. Current scenario of diabetes in India. J Diabetes. 2009;1(1):18-28.
Hilton CW, Mizuma H, Svec F, Prasad C. Relationship between plasma cyclo (His-Pro), a neuropeptide common to processed protein-rich food, and C-peptide/insulin molar ratio in obese women. Nutr Neurosci. 2001;4(6):469-74.
Vikhe VB, Kanitkar SA, Tamakuwala KK, Gaikwad AN, Kalyan M, Agarwal RR. Thyroid dysfunction in patients with type 2 diabetes mellitus at tertiary care centre. Natl J Med Res. 2013;3(4):377-80.
Papazafiropoulou A, Sotiropoulos A, Kokolaki A, Kardara M, Stamataki P, Pappas S. Prevalence of thyroid dysfunction among greek type 2 diabetic patients attending an outpatient clinic. J Clin Med Res. 2010;2(2):75.
Singh G, Gupta V, Sharma AK, Gupta N. Frequency of thyroid dysfunction among diabetes in Punjabi population. Adv Biores. 2011;2:3-9.
Schlienger JL, Anceau A, Chabrier G, North ML, Stephan F. Effect of diabetic control on the level of circulating thyroid hormones. Diabetologia. 1982; 22(6):486-8.
Donckier JE. Endocrine disease and diabetes. In: text book of diabetes mellitus. Pickup JC Williams G, eds. UK: Blackwell Publishing Company; 2003:24;21-9.
Feely J, Isles TE. Screening for thyroid dysfunction in diabetics. Br Med J. 1979;2(6202):1439.
Dimitriadis G, Baker B, Marsh H, Mandarino L, Rizza R, Bergman R, et al. Effect of thyroid hormone excess on action, secretion, and metabolism of insulin in humans. Am J Physiol Metab. 1985;248(5):E593-601.
Ortega E, Koska J, Pannacciulli N, Bunt JC, Krakoff J. Free triiodothyronine plasma concentrations are positively associated with insulin secretion in euthyroid individuals. Eur J Endocrinol Fed Endocr Soc. 2008;158(2):217.
Handisurya A, Pacini G, Tura A, Gessl A, Kautzky‐Willer A. Effects of T4 replacement therapy on glucose metabolism in subjects with subclinical (SH) and overt hypothyroidism (OH). Clin Endocrinol. 2008;69(6): 963-9.
Mohn A, Di Michele S, Di Luzio R, Tumini S, Chiarelli F. The effect of subclinical hypothyroidism on metabolic control in children and adolescents with type 1 diabetes mellitus. Diabet Med. 2002;19(1):70-3.
Maratou E, Hadjidakis DJ, Kollias A, Tsegka K, Peppa M, Alevizaki M, et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol. 2009;160(5):785.
Kadiyala R, Peter R, Okosieme OE. Thyroid dysfunction in patients with diabetes: clinical implications and screening strategies. Int J Clin Pract. 2010;64(8):1130-9.
Das AK, Rao P V, Madhu S V, Mohan V. Textbook of diabetes mellitus. New Delhi, India: Jaypee Brothers Medical Publishers (P) Ltd; 2014.
Larsen P, Kronenberg H, Melmed S, Polonsky K. Williams textbook of endocrinology. Philadelphia: Elsevier Inc; 2003.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2163-96.
Gale EAM, Gillespie KM. Diabetes and gender. Diabetologia. 2001;44(1):3-15.
Meisinger C, Thorand B, Schneider A, Stieber J, Döring A, Löwel H. Sex differences in risk factors for incident type 2 diabetes mellitus: the MONICA Augsburg cohort study. Arch Intern Med. 2002; 162(1):82-9.
Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442.
Radaideh AR, Mo MK, Amari FL, Bateiha AE, El-Khateeb MP, Naser PA, et al. diabetes mellitus in Jordan. Saudi Med J. 2004;25(8):1046-50.
Michalaki MA, Vagenakis AG, Leonardou AS, Argentou MN, Habeos IG, Makri MG, et al. Thyroid function in humans with morbid obesity. Thyroid. 2006;16(1):73-8.
Global report on diabetes. Available at: https://www.who.int/. Accessed on 20 October 2021.
Shi Y, Hu FB. The global implications of diabetes and cancer. Lancet. 2014;383(9933):1947-8.
Chubb SAP, Davis WA, Inman Z, Davis TME. Prevalence and progression of subclinical hypothyroidism in women with type 2 diabetes: the fremantle diabetes study. Clin Endocrinol. 2005; 62(4):480-6.
Chen H, Wu T, Jap T, Lu R, Wang M, Chen R, et al. Subclinical hypothyroidism is a risk factor for nephropathy and cardiovascular diseases in type 2 diabetic patients. Diabet Med. 2007;24(12):1336-44.
Jain A, Prakash Patel R. A study of Thyroid disorder in Type 2 Diabetes Mellitus. Sch J App Med Sci. 2016; 4(12B):4318-20.
Agrawal N, Gulati M. Study of prevalence of thyroid dysfunction in patients with type 2 diabetes mellitus. Int J Contemp Med Res. 2016;3(8):2212-4.
Diez JJ, Sánchez P, Iglesias P. Prevalence of thyroid dysfunction in patients with type 2 diabetes. Exp Clin Endocrinol Diabetes. 2011;119(04):201-7.
Akbar DH, Ahmed MM, Al-Mughales J. Thyroid dysfunction and thyroid autoimmunity in Saudi type 2 diabetics. Acta Diabetol. 2006;43(1):14-8.
Telwani AA, Wani ZH, Ashraf Y, Shah AA. Prevalence of thyroid dysfunction in type 2 diabetes mellitus: a case control study. Int J Res Med Sci. 2017;5(10):4527-31.
Celani MF, Bonati ME, Stucci N. Prevalence of abnormal thyrotropin concentrations measured by a sensitive assay in patients with type 2 diabetes mellitus. Diabetes Res. 1994;27(1):15-25.
Vondra K, Vrbikova J, Dvorakova K. Thyroid gland diseases in adult patients with diabetes mellitus. Minerva Endocrinol. 2005;30(4):217-36.
Babu K, Kakar A, Byotra SP. Prevalence of thyroid disorder in type II diabetes mellitus patients. J Assoc Phys Ind. 2001;49:43.
Boelaert K, Newby PR, Simmonds MJ, Holder RL, Carr-Smith JD, Heward JM, et al. Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am J Med. 2010; 123(2):183-e1.
Al-Geffari M, Ahmad NA, Al-Sharqawi AH, Youssef AM, AlNaqeb D, Al-Rubeaan K. Risk factors for thyroid dysfunction among type 2 diabetic patients in a highly diabetes mellitus prevalent society. Int J Endocrinol. 2013;2013.
Schroner Z, Lazurova I, Petrovicova J. Autoimmune thyroid diseases in patients with diabetes mellitus. Bratisl Lek Listy. 2008;109(3):125-9.
Michalek AM, Mahoney MC, Calebaugh D. Hypothyroidism and diabetes mellitus in an American Indian population. J Fam Pract. 2000;49(7):638.
Elmenshawi I, Alotaibi S, Alazmi A, Alazmi A, Alruwaili F, Alazmi N, et al. Prevalence of thyroid dysfunction in diabetic patients. J Diabetes Metab Disord Control. 2017;4:55-6.
Jarallah JS, Al-Rubeaan KA, Al-Nuaim ARA, Al-Ruhaily AA, Kalantan KA. Prevalence and determinants of smoking in three regions of Saudi Arabia. Tob Control. 1999;8(1):53-6.
Fisher CL, Mannino DM, Herman WH, Frumkin H. Cigarette smoking and thyroid hormone levels in males. Int J Epidemiol. 1997;26(5):972-7.