Title: Across Sectional Study on Thyroid Profile in Type II Diabetes Mellitus

Authors: Rajhounsh V, Dilip M Rampure, L Suresh Kumar, Santhosh Kumar Cheekoti

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i4.26

Abstract

Background & Objectives: Diabetes mellitus (DM) is a common endocrine disorder which involves multiple organ systems and leads to significant morbidity and mortality due to accompanying complications. DM has been defined as A METABOLIC SYNDROME characterized by chronic hyperglycemia & disturbance in carbohydrate, fat, protein metabolism with absolute or relative deficiency in insulin secretion or insulin action. There are macro and micro vascular complications of diabetes involving kidneys, eyes, blood vessels, nerves and heart. Thyroid diseases are also a common endocrinopathy seen in adult population.

Thyroid hormones are intimately involved in cellular metabolism. Thus excess or deficit of either insulin or thyroid hormones could result in functional derangement of cellular metabolism. This study would be an attempt to study the prevalence of thyroid disorders in patients with type II diabetes.

Materials & Methods: This cross sectional study included 100 patients with type II diabetes without previous thyroid abnormalities after meeting inclusion criteria during Jan 2015 to June 2015 held at Mamata Medical College & General Hospital- Khammam, TS state.

Results: Out of 100 patients with type II DM, 14 had abnormal thyroid profile of which 13 had subclinical hypothyroidism, 1 patient had overt hypothyroidism, 61% were females, more among those with duration up to 5 years (68%).

Conclusion: The prevalence of thyroid dysfunction is more common among type II DM patients than in general population. The prevalence is higher in females than in males.

Key Words: Type II Diabetes Mellitus (DM), Metabolicsyndrome, Subclinical hypothyroidism.

References

1.      Peter H. Bennett, William C. Knowlap. Definition, diagnosis and classification of diabetes. Josin’s diabetes mellitus 14th edition, 2005: 331-337.

2.      Alvin C. Powers. Diabetes mellitus. Harrison’s principles of internal medicine 18th edition, 2012: 2968-3003.

3.      IDF Diabetes atlas 5th edition, 2012.

4.      American Diabetes Association, Standards of medical care in Diabetes-2013. Diabetes Care, Volume 36, Supplement 1, January 2013.

5.      Kalmann R, Mourits M. Diabetes Mellitus: a risk factor in patients with Grave’s orbitopathy. Br. J. Ophthalmol 1999; 83:463-465.

6.      Coiro V, Volpi R, Marchesi C, et al. Influence of residual C-peptide secretion on nocturnal serum TSH peak in well-controlled diabetic patients. Clin. Endocrinal. 1997; 47: 305-10.

7.      Thyroid and anti thyroid drugs. Katzung Basic clinical pharmacology 10th edition, 2007: 618-634.

8.      J. Larry Jameson, Anthony P. Weetman. Disorders of thyroid gland. Harrison’s principles of internal medicine, 18th edition, 2012: 2911-2939.

9.      Kapur A, Snehalatha C, Ramachandran A, Vijay V, Mohan V, Das AK, Rao PV, Yajnik C S, Prasanna Kumar K M, Jyotsna  Nair: High prevalence of diabetes and impaired glucose tolerance in India. National Urban diabetes survey. Diabetolgia 2001; Vol. 44: 1094-1101.

10.  Arthur M. Michalek, Martin C. Mahoney, Donald Calebaugh: Hypothyroidism and Diabetes Mellitus in an American Population. Journal of family practice 2000 July; 49: 638-640.

11.  Jali MV, Mohan V, Ramachandran A, Snehalatha C and Vishwanathan M; High prevalence of diabetes in an urban population in South India. BMJ Sep 1988; Vol. 297: 587-590.

12.  Flatau E, Trougouboff P, Kaufman N, Reichman N, Luboshitzky R. Prevalence of  hypothyroidism and diabetes mellitus in elderly kibbutz members. European Journal of Epidemiology, Volume 16, Number 1, January 2000, 43-46 (4).

13.  Tattersal R B, Fojans S, Arbor A: Prevalence of Diabetes and Glucose Intolerance in offsprings of 37 conjugal diabetic parents. Diabetes 1975, 24: 452-462.

14.  Vishwanathan M, Mohan V, Snehalatha C, Ramachandran A. High prevalence of type 2 diabetes among the offspring of conjugal type 2 parents in India. Diabetolgia, 1985, 28: 907-910.

15.  Paolo Fumelli, Silvia Natalucci, Massimo Boemi. One and two compartment minimal models detect similar alterations of glucose metabolism indexes in hypertension. Metabolism, Volume 49; 12: 1529-1536.

16.  Abdel Rahman, Nusier M K, Amari F L et al. Thyroid dysfunction in patients with type 2 Diabetes mellitus in Jordan. Saudi Med J. 2004 Aug 25 (8): 1046-50.

17.  Chubb SA, Davis WA, Inman Z, Davis D M E. Prevalence and progression of subclinical hypothyroidism in women with type 2 diabetes: The Fremantle diabetes study. ClinEndrocrinol (Oxf). 2005 Apr; 62 (4): 480-6.

18.  Akbar D H, Ahmed MM, Al-MughalsJ. Thyroid dysfunction and thyroid auto immunity in Saudi type 2 diabetics. Acta Diabetologica. 2006 May; 43(1): 14-18.

19.  Smithson MJ. Screening for thyroid dysfunction in a community population of diabetic patients. Diabet Med 1998; 15 (2): 148-50.

20.  Celani MF, Bonati ME, Stucci N. Prevalence of abnormal thyrotropin concentrations in measured by a sensitive assay in patients with type 2 diabetes mellitus. Diabetes Res 1994; 27: 15-25.

21.  Vondra K, Vrbikova J, Dyorakova K. Thyroid gland diseases in adult patients with diabetes mellitus. Minerva Endrocrinol. 2005 Dec; 30(4):217-36.

Corresponding Author

Santhosh Kumar Cheekoti

Post Graduate, Dept of General Medicine, Mamata Medical College & General Hospital,

Khammam-507002, Telangana State