Abstract
Introduction: Diabetes mellitus (DM) is fast spreading in developed as well as developing world. With improvements in socioeconomic status and a sedentary life style more and more people are getting affected at a relatively younger age. There are various studies which have reported that there is an increased incidence of thyroid abnormalities in patients with diabetes mellitus. Moreover, presence of thyroid abnormalities is associated with poor metabolic control. Therefore we conducted this study to compare thyroid function in patients with diabetes mellitus type II and healthy individuals.
Materials and Methods: This was a case control study in which 80 patients with Diabetes Mellitus Type II and 80 age matched healthy individuals were included on the basis of a predefined inclusion and exclusion criteria. A detailed history was taken in all the cases with particular attention on duration of diabetes mellitus and presence of other systemic illnesses. Patients were classified as to be having subclinical hypothyroidism (TSH- 4.5 to 10 and normal free T4), Overt hypothyroidism (TSH more than 10 with low free T4 levels), hyperthyroidism (TSH less than 0.45 and raised free T4) and subclinical hyperthyroidism (TSH less than 0.45 and raised free T4). For statistical purposes p value less than 0.05 was taken as statistically significant.
Results: Out of total 160 individuals enrolled in this study there were 92 (57.50%) females and 68 (42.50%) males with a M:F ratio of 1:0.73. The age groups were found to be comparable and there was no statistically significant difference in mean age of both the groups (p=0.53). The comparison of the patients of both the groups on the basis of whether they had a normal or abnormal thyroid function test showed that patients with diabetes mellitus type 2 were more likely to be having abnormal thyroid function test as compared to healthy individuals and the difference was found to be statistically significant (p=0.043).
Conclusion: Thyroid abnormalities are more common in patients with diabetes mellitus type II as compared to age matched healthy individuals. It is therefor important from point of view of a treating physician to screen patients with DM type II for presence of thyroid function abnormalities.
Keywords: Diabetes Mellitus Type II, Thyroid function abnormalities, Free T4, TSH.
References
- Lin Y, Sun Z. Current views on type 2 diabetes. J Endocrinol. 2010;204(1):1–11.
- Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, Malanda B. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018 Apr;138:271-281.
- Lichtenauer UD, Seissler J, Scherbaum WA. [Diabetic complications. Micro and macro-angiopathic end-organ damage]. Internist (Berl). 2003 Jul;44(7):840-6, 848-52.
- Samuels TA, Cohen D, Brancati FL, Coresh J, Kao WH. Delayed diagnosis of incident type 2 diabetes mellitus in the ARIC study. Am J Manag Care. 2006 Dec;12(12):717-24.
- Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights. 2016;11:95–104. Published 2016 Jul 3.
- Wang W, Lo ACY. Diabetic Retinopathy: Pathophysiology and Treatments. Int J Mol Sci. 2018;19(6):1816. Published 2018 Jun 20.
- Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6(13):1246–1258.
- Coller FA, Huggins CB. Effect of hyperthyroidism upon diabetes mellitus: striking improvement in diabetes mellitus from thyroidectomy. Annals of Surgery.1927;86(6):877–884.
- Perros P, McCrimmon RJ, Shaw G, Frier BM. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabetic Medicine.1995;12(7):622–627.
- Franco JS, Amaya-Amaya J, Anaya JM. Thyroid disease and autoimmune diseases. In: Anaya JM, Shoenfeld Y, Rojas-Villarraga A, et al., editors. Autoimmunity: From Bench to Bedside [Internet]. Bogota (Colombia): El Rosario University Press; 2013 Jul 18. Chapter 30.Available from: https://www.ncbi.nlm.nih.gov/books/NBK459466/
- Uppal V, Vij C, Bedi GK, Vij A, Banerjee BD. Thyroid disorders in patients of type 2 diabetes mellitus. Indian J Clin Biochem. 2013;28(4):336–341.
- Demitrost L, Ranabir S. Thyroid dysfunction in type 2 diabetes mellitus: A retrospective study. Indian J Endocrinol Metab. 2012;16(Suppl 2):S334–S335.
- Chen G, Wu J, Lin Y, et al. Associations between cardiovascular risk, insulin resistance, β-cell function and thyroid dysfunction: a cross-sectional study in She ethnic minority group of Fujian Province in China. European Journal of Endocrinology. 2010;163(5):775–782.
- Kouidhi S, Berhouma R, Ammar M, Rouissi K, Jarboui S, Clerget-Froidevaux MS, Seugnet I, Abid H, Bchir F, Demeneix B, Guissouma H, Elgaaied AB. Relationship of thyroid function with obesity and type 2 diabetes in euthyroid Tunisian subjects. Endocr Res. 2013;38(1):15-23.
- Reddy KS, Pragnanjali E, Dorsanamma M, Nagabushana MV. A study of prevalence of thyroid disorders in type 2 diabetic patients in tertiary care hospital. Int J Adv Med 2018; 5:1383-7.
Corresponding Author
Radhika Manjeshwar (M.B.B.S.)
Medical Officer, Primary Health Center Edu, Karnataka, India