THYROID DYSFUNCTION IN PATIENTS WITH TYPE 1 DIABETES AT A TERTIARY CARE HOSPITAL

Authors

  • TZ KHAN ICU Hayatabad Medical Complex Peshawar, Pakistan
  • SMU SHAH BHU Tellaband District Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1255

Keywords:

Thyroid dysfunction, Patients, Type 1 diabetes

Abstract

Individuals with diabetes mellitus (DM) are reporting thyroid dysfunction at an alarming rate, and there's evidence that thyroid dysfunction—whether overt or subclinical—affects overall glycaemic control. 12.3% of individuals with Type 1 DM have overt hypothyroidism, while around 24.8% of patients have abnormal thyroid autoantibody levels. Objective: This study aimed to determine Thyroid dysfunction in patients with type 1 diabetes at a tertiary care hospital. Methods: The present descriptive study was carried out at Hayatabad Medical Complex Peshawar from January 2024 to June 2024 after obtaining permission from the ethical committee of the institute. A total of 110 participants were enrolled in the study. We included all T1DM patients of both genders. All participants with T1DM visiting the OPD were screened. The primary test for assessing thyroid function was TSH, which has an acceptable range from 0.5 to 5 mIU/ml. Triiodothyronine (T3) and free thyroxin (FT4) levels were also measured. On a Cobos 6000 machine (Roche), thyroid function tests (TFTs) were performed. Data was analyzed through SPSS version 22.0. Results: A total of 110 participants of both genders of different age groups were enrolled in this study. 63.63% of them were females and 36.36% were males. 18 individuals (16.36%) had subclinical hypothyroidism, 14 individuals (12.7%) were hypothyroid, and 78 of them (70.90%) were euthyroid. We did not identify any occurrences of hyperthyroidism in current research. In comparison to the rest of the population, individuals with hypothyroidism had significantly different mean Thyroid stimulating hormone, FT4 and FT3 levels (p <0.0001). The mean differences for age, the period of diabetes, randomized blood sugar (RBS), and HbA1c were not statistically significant. When the data was examined for subclinical hypothyroidism, however, there was a substantial variance for mean Thyroid stimulating hormone (p <0.0001) but not for FT4 or FT3. Likewise, there was no difference seen in age (p= 0.35) or gender (p= 0.63). Conclusion: Type 1 diabetes individuals often suffer from thyroid dysfunctions particularly hypothyroidism (12.7%) and subclinical hypothyroidism (16.36%). The analysis of thyroid-stimulating hormone levels and other hormonal markers for thyroid function is the most crucial approach.

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References

Wang C, Crapo LM. The epidemiology of thyroid disease and implications for screening. Endocrinology and Metabolism Clinics. 1997;26(1):189-218.

Triolo TM, Armstrong TK, McFann K, Yu L, Rewers MJ, Klingensmith GJ, et al. Additional autoimmune disease found in 33% of patients at type 1 diabetes onset. Diabetes care. 2011;34(5):1211-3.

Dosi RV, Tandon N. A study on prevalence of thyroid auto-immunity in type 1 diabetes mellitus. Journal of the Indian Medical Association. 2010;108(6):349-50, 55.

Atkinson MA, Eisenbarth GS. Type 1 diabetes: new perspectives on disease pathogenesis and treatment. The Lancet. 2001;358(9277):221-9.

Shun C, Donaghue K, Phelan H, Twigg S, Craig M. Thyroid autoimmunity in Type 1 diabetes: systematic review and meta‐analysis. Diabetic Medicine. 2014;31(2):126-35.

Taieb A, Yosra H, Amel M, Maha K, Molka C, Koussay A, editors. Thyroid disorders and type 1 diabetes. Endocrine Abstracts; 2017: Bioscientifica.

Chiang J, Kirkman M, Laffel L. Peters AL; Type 1 Diabetes Sourcebook Authors. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes care. 2014;37(7):2034-54.

Joseph J, Saroha V, Payne H, Paul P, Didi M, Isherwood D, et al. Thyroid function at diagnosis of type I diabetes. Archives of disease in childhood. 2011;96(8):777-9.

Barker JM. Type 1 diabetes-associated autoimmunity: natural history, genetic associations, and screening. The Journal of Clinical Endocrinology & Metabolism. 2006;91(4):1210-7.

Van den Driessche A, Eenkhoorn V, Van Gaal L, De Block C. Type 1 diabetes and autoimmune polyglandular syndrome: a clinical review. Neth J Med. 2009;67(11):376-87.

Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Archives of internal medicine. 2000;160(4):526-34.

Severinski S, Banac S, Smiljan Severinski N, Ahel V, Cvijović K. Epidemiology and clinical characteristics of thyroid dysfunction in children and adolescents with type 1 diabetes. Collegium antropologicum. 2009;33(1):273-9.

Ardestani SK, Keshteli AH, Khalili N, Hashemipour M, Barekatain R. Thyroid disorders in children and adolescents with type 1 diabetes mellitus in Isfahan, Iran. Iranian journal of pediatrics. 2011;21(4):502.

Umpierrez GE, Latif KA, Murphy MB, Lambeth HC, Stentz F, Bush A, et al. Thyroid dysfunction in patients with type 1 diabetes: a longitudinal study. Diabetes care. 2003;26(4):1181-5.

Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, et al. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). The Journal of Clinical Endocrinology & Metabolism. 2002;87(2):489-99.

Maahs DM, West NA, Lawrence JM, Mayer-Davis EJ. Epidemiology of type 1 diabetes. Endocrinology and Metabolism Clinics. 2010;39(3):481-97.

Kadiyala R, Peter R, Okosieme OE. Thyroid dysfunction in patients with diabetes: clinical implications and screening strategies. International journal of clinical practice. 2010;64(8):1130-9.

Aljabri KS. Hypothyroidism in Saudi patients with type 1 Diabetes Mellitus. Diabetes. 2019;1(1):001-5.

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. Diabetic Medicine. 2002;19(1):70-3.

Donner H, Rau H, Walfish PG, Braun J, Siegmund T, Finke R, et al. CTLA4 alanine-17 confers genetic susceptibility to Graves’ disease and to type 1 diabetes mellitus. The Journal of Clinical Endocrinology & Metabolism. 1997;82(1):143-6.

Hage M, Zantout MS, Azar ST. Thyroid disorders and diabetes mellitus. Journal of thyroid research. 2011;2011(1):439463.

Ikegami H, Awata T, Kawasaki E, Kobayashi T, Maruyama T, Nakanishi K, et al. The association of CTLA4 polymorphism with type 1 diabetes is concentrated in patients complicated with autoimmune thyroid disease: a multicenter collaborative study in Japan. The Journal of Clinical Endocrinology & Metabolism. 2006;91(3):1087-92.

Plagnol V, Howson JM, Smyth DJ, Walker N, Hafler JP, Wallace C, et al. Genome-wide association analysis of autoantibody positivity in type 1 diabetes cases. PLoS genetics. 2011;7(8):e1002216.

Fatourechi A, Ardakani HM, Sayarifard F, Sheikh M. Hypothyroidism among pediatric patients with type 1 diabetes mellitus, from patients’ characteristics to disease severity. Clinical Pediatric Endocrinology. 2017;26(2):73-80.

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Published

2024-10-31

How to Cite

KHAN, T., & SHAH, S. (2024). THYROID DYSFUNCTION IN PATIENTS WITH TYPE 1 DIABETES AT A TERTIARY CARE HOSPITAL. Biological and Clinical Sciences Research Journal, 2024(1), 1255. https://doi.org/10.54112/bcsrj.v2024i1.1255