Abstract

Introduction: Type II diabetes and thyroid disorder are the two most commonly encountered endocrine disorders in our community. The presence of thyroid disorder in patients with diabetes deteriorates the glycemic control and hence increases the incidence of complications. Hence the prevalence of thyroid disorder in patients with T2DM needs to be investigated.

Aims and Objectives: The present study is done to study the frequency of thyroid disorders in patients with type 2 Diabetes mellitus patients and to determine the subtypes of thyroid disorders in patients with type 2 diabetes mellitus.

Materials and Methods: In this cross sectional study, data of 110 type II diabetes mellitus patients visiting the OPD and IPD of the department of general medicine of Sri Siddhartha Medical College hospital, Tumkur are included. Inclusion criteria are all patients with T2dm with onset of diabetes ≥30 years with duration of diabetes ≥6 months. Exclusion criteria are patients with T1DM, gestational DM, pancreatitis, & steroid induced diabetes.

Results: Out of the 110 diabetic patients 43(39.1%) are males and 67(60.9%) are females; 73 (66.4%) are euthyroid, 24 (21.8 %) have sub-clinical hypothyroidism (5 males & 19 females), 8 (7.3%) have clinical hypothyroidism (7 females and 1 male), 3 (2.9%) have clinical hyperthyroidism (2 male & 1 female) & 2 (1.8%) have subclinical hyperthyroidism (both females).

• BMI was significantly higher in T2DM patients with thyroid dysfunction (p=0.027) especially in patients with subclinical hypothyroidism (p=0.034).
• The incidence of thyroid dysfunction was higher in female T2DM patient’s than their male counterparts (p=0.008).
• The incidence of hypertension was higher among T2DM patients with thyroid dysfunction than the euthyroid T2DM patients (p=0.035).
• Mean FBS & PPBS was significantly higher in T2DM patient’s with thyroid dysfunction when compared to T2DM patient’s without thyroid dysfunction (p < 0.001& p<0.001 respectively.
• Poor achievement of the guideline recommended target of FBS & PPBS was seen in T2DM patients (p<0.001 & p<0.001 respectively) with thyroid dysfunction, especially in patients with sub-clinical hypothyroidism (p<0.001 & p=0.001 respectively).
• FBS & PPBS were significantly higher in patients with higher BMI. (p=0.014 & p=0.027 respectively.)

Conclusions: There is an increased frequency of thyroid disorders in patients with T2DM, especially in female diabetics& in diabetics with higher BMI. The glycemic control was also poor in T2DM patients with thyroid dysfunction, especially among the Sub-clinical hypothyroid patients. There was also higher incidence of hypertension among T2DM patients with thyroid dysfunction. Hence, routine screening for thyroid dysfunction in type 2 diabetes mellitus patients may be justified especially in females and in patients with higher BMI.

Keywords: Type 2 diabetes mellitus, hypothyroidism, subclinical hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, BMI.

MeSH Terms: Diabetes Mellitus, Type II Type 2 Diabetes, Type 2 Diabetes Mellitus.