1- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Mangalgiri, Andhra Pradesh, India
2- Department of Biochemistry, Government Medical College, Anantapuramu, Andhra Pradesh, India
3- Department of Pharmacology, Government Medical College Paderu, Andhra Pradesh, India ,drmamajeed@yahoo.com
2- Department of Biochemistry, Government Medical College, Anantapuramu, Andhra Pradesh, India
3- Department of Pharmacology, Government Medical College Paderu, Andhra Pradesh, India ,
Abstract: (15 Views)
Background: Type 2 diabetes mellitus (T2DM) and thyroid dysfunction are recognized as two of the most widespread endocrine conditions in clinical settings. Untreated thyroid dysfunction can detrimentally affect the metabolic management of individuals with diabetes. Despite the significant metabolic interplay between these disorders, thyroid dysfunction frequently goes undetected in diabetic populations. Specifically, subclinical hypothyroidism has been linked to compromised glycemic control and an elevated risk of cardiovascular events. Consequently, this study is designed to assess the prevalence and specific profile of thyroid hormone alterations among T2DM patients. It also aims to investigate the relationship of these alterations with key clinical factors, including glycemic control (glycated hemoglobin [HbA1c]), duration of diabetes, and patient demographics (gender and age).
Methods: The current cross-sectional observational study was carried out at a tertiary care teaching hospital. In this study enrolled 200 participants. These individuals were systematically divided into two equally sized groups: A patient group comprising participants aged 30 to 70 years diagnosed with T2DM, and a control group consisting of healthy individuals precisely matched for both age and gender. An in-depth patient history was initially collected, succeeded by a clinical examination and a biochemical assessment. Comprehensive data encompassing demographic characteristics and biochemical markers were acquired and compiled.
Results: The research uncovered varying patterns of thyroid dysfunction among T2DM subjects, with subclinical hypothyroidism identified as the leading manifestation (24%). The occurrence rate of thyroid dysfunction was markedly elevated in the T2DM cohort relative to the non-diabetic reference group (p < 0.001). A strong, statistically significant positive association (r = 0.76, p < 0.001) emerged between increased TSH concentrations and inadequate glycemic control (HbA1c > 8%). Thyroid dysfunction demonstrated a higher frequency specifically in postmenopausal women and in patients whose duration of diabetes exceeded 5 years.
Conclusion: The result of study showed that the implementation of standardized, stratified thyroid screening protocols is recommended for all T2DM patients during their initial diagnostic evaluation. An annual follow-up is also advised, with particular emphasis on high-risk subsets. This proactive approach facilitates early identification of thyroid dysfunction, thereby mitigating associated diabetic complications and optimizing integrated endocrine management.
Methods: The current cross-sectional observational study was carried out at a tertiary care teaching hospital. In this study enrolled 200 participants. These individuals were systematically divided into two equally sized groups: A patient group comprising participants aged 30 to 70 years diagnosed with T2DM, and a control group consisting of healthy individuals precisely matched for both age and gender. An in-depth patient history was initially collected, succeeded by a clinical examination and a biochemical assessment. Comprehensive data encompassing demographic characteristics and biochemical markers were acquired and compiled.
Results: The research uncovered varying patterns of thyroid dysfunction among T2DM subjects, with subclinical hypothyroidism identified as the leading manifestation (24%). The occurrence rate of thyroid dysfunction was markedly elevated in the T2DM cohort relative to the non-diabetic reference group (p < 0.001). A strong, statistically significant positive association (r = 0.76, p < 0.001) emerged between increased TSH concentrations and inadequate glycemic control (HbA1c > 8%). Thyroid dysfunction demonstrated a higher frequency specifically in postmenopausal women and in patients whose duration of diabetes exceeded 5 years.
Conclusion: The result of study showed that the implementation of standardized, stratified thyroid screening protocols is recommended for all T2DM patients during their initial diagnostic evaluation. An annual follow-up is also advised, with particular emphasis on high-risk subsets. This proactive approach facilitates early identification of thyroid dysfunction, thereby mitigating associated diabetic complications and optimizing integrated endocrine management.
Keywords: Type 2 Diabetes Mellitus, Hypothyroidism, Glycosylated Hemoglobin A1c, Thyroid Stimulating Hormone, Endocrine System, Thyroid dysfunction
Article Type: Research |
Subject:
Biochemistry
References
1. Wang C. The Relationship between Type 2 Diabetes Mellitus and Related Thyroid Diseases. J Diabetes Res. 2013;2013:390534. [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Mehalingam V, Sahoo J, Bobby Z, Vinod KV. Thyroid dysfunction in patients with type 2 diabetes mellitus and its association with diabetic complications. J Family Med Prim Care. 2020;9(8):4277-81. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Biondi B, Kahaly GJ, Robertson RP. (2019). Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders. Endocr Rev. 2019;40(3):789-824. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Vondra K, Vrbikova J, Dvorakova K. Thyroid gland diseases in adult patients with diabetes mellitus. Minerva Endocrinol. 2005;30(4):217-36. [View at Publisher] [PMID] [Google Scholar]
5. Wartofsky L, Burman KD. Alterations in thyroid function in patients with systemic illness: the "euthyroid sick syndrome". Endocr Rev. 1982;3(2):164-217. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Hage M, Zantout MS, Azar ST. Thyroid Disorders and Diabetes Mellitus. J Thyroid Res. 2011:2011:439463. [View at Publisher] [DOI] [PMID] [Google Scholar]
7. Kalra S, Aggarwal S, Khandelwal D. Thyroid Dysfunction and Type 2 Diabetes Mellitus: Screening Strategies and Implications for Management. Diabetes Ther. 2019;10(6):2035-44. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA. 2004;291(2):228-38. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Burtis CA, Ashwood ER, Bruns DE. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. St. Louis, MO: Elsevier; 2018 [View at Publisher]
10. American Diabetes Association Professional Practice Committee. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care. 2024;47(1):17-27. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Cappelli C, et al. TSH-lowering effect of metformin in euthyroid patients with type 2 diabetes. J Clin Endocrinol Metab. 2006;91(1):225-9.
12. Radaideh A-RM, Nusier MK, Amari FL, Bateiha AE, El-Khateeb MS, Naser AS, et al. Thyroid dysfunction in patients with type 2 diabetes mellitus in Jordan. Saudi Med J. 2004;25(8):1046-50. [View at Publisher] [PMID] [Google Scholar]
13. 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. 2013:2013:417920. [View at Publisher] [DOI] [PMID] [Google Scholar]
14. Akbar DH, Ahmed MM, Al-Mughales J. Thyroid dysfunction and thyroid autoimmunity in Saudi type 2 diabetics. Acta Diabetol. 2006;43(1):14-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
15. Akhtar A, Sah SP. Insulin signaling pathway and related molecules: Role in neurodegeneration and Alzheimer's disease. Neurochem Int. 2020;135:104707. [View at Publisher] [DOI] [PMID] [Google Scholar]
16. Shrestha B, Rai CK. Hypothyroidism among Type 2 Diabetic Patients Visiting Outpatient Department of Internal Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2023;61(260):325-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
17. Csiha S, Molnár I, Halmi S, Hutkai D, Lőrincz H, Somodi S, et al. Advanced glycation end products and their soluble receptor (sRAGE) in patients with Hashimoto's thyroiditis on levothyroxine substitution. Front Endocrinal (Lausanne). 2023;14:1187725. [View at Publisher] [DOI] [PMID] [Google Scholar]
18. González P, Lozano P, Ros G, Solano F. Hyperglycemia and Oxidative Stress: An Integral, Updated and Critical Overview of Their Metabolic Interconnections. Int J Mol Sci. 2023;24(11):9352. [View at Publisher] [DOI] [PMID] [Google Scholar]
19. Fiorentino TV, Prioletta A, Zuo P, Folli F. Hyperglycemia-induced oxidative stress and its role in diabetes mellitus related cardiovascular diseases. Curr Pharm Des. 2013;19(32):5695-703. [View at Publisher] [DOI] [PMID] [Google Scholar]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0).
