A study of prevalence of primary hypothyroidism in recently diagnosed type 2 diabetes mellitus in a tertiary care hospital

Authors

  • Sudeb Mukherjee MD (PGT) Resident, Department Of General Medicine, R.G.Kar Medical College & Hospital Kolkata
  • Suhana Datta MBBS, Junior Resident, Department of General Medicine, R.G.Kar Medical College and Hospital kolkata
  • Pramathanath Datta MS, Assistant Professor, Department Of Surgery, K. P. C. Medical College , Kolkata, West Bengal, India
  • Apurba K. Mukherjee MD. Professor & H.O.D. of Department of General Medicine, R.G.Kar Medical College, Kolkata,
  • Indira Maisnam MD, DM (Endocrinology) Assistant Professor, Department Of Medicine, R.G.Kar Medical College, Kolkata

DOI:

https://doi.org/10.18203/issn.2454-2156.IntJSciRep20150216

Keywords:

DM (Diabetes mellitus), SH (Subclinical hypothyroidism, FT4 (Free levohyroxine), TSH (Thyroid stimulating hormone)

Abstract

Background: The association between thyroid dysfunction and DM has long been recognized, although the prevalence of thyroid dysfunction among diabetes population varies in different studies. This study destined to know the prevalence of thyroid dysfunction of recently diagnosed type 2 diabetes mellitus patients.  

Methods: Retrospective chart review of 60 patients with type 2 diabetes mellituswas done. Total 60 patients (male 51, female9) fulfillingdiagnostic criteria for diabetes mellitus according to ADA (American Diabetes Association) criteria were analysed by doing Thyroid Function Test (FT4,TSH).

Results: 75% of patients have the biochemical features of thyroid dysfunction. Subcategorically in descending order of frequency they are - Subclinical hypothyroidism (33.33%) (defined by no symptoms or clinical fetures of hypothyroidism but biochemically TSH level in the range of above 5 mIU/ml but below 10 mIU/ml with normal FT4 level), 15% of patients each for overt hypothyroidism (either clinical features or Biochemically TSH >10 mIU/ml or FT4 below normal), and subclinical hyperthyroidism (only biochemical low level of TSH <0.34 mIU/ml in this study) and 11.667% patients show the features of clinical hyperthyroidism (clinical or FT4 level well above normal range along with low TSH).

Conclusions: Avery high prevalence of thyroid dysfunction in this part of world in contrast to Europe & US suggest routine screening for thyroid disorder in recently diagnosed type 2 diabetes mellitus.

Metrics

Metrics Loading ...

References

Alvin C. Powers. Diabetes mellitus. In: Dan L. Longo, Dennis L. Kasper, eds. Harrison’s Principle of Internal Medicine. 18th ed. New York: McGraw-Hill Publication; 2001: 2968.

IDF. Diabetes atlas, 2015. Available at: http://www.idf.org/diabetesatlas/5e/regional-overviews.

Chan JC1, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, et al. Diabetes in Asia: Epidemiology, risk factors, and pathophysiology. JAMA. 2009 May;301(20):2129-40.

Heuck CC, Kallner A, Kanagasabapathy AS, Riesen W. Diagnosis and monitoring of diseases of the thyroid. In: WHO, eds. WHO Report. Geneva: WHO; 2000: 8-9.

Perros P, McCrimmon RJ, Shaw G, Frier BM. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet Med. 1995;12(7):622-7.

Cooppan R, Kozak GP. Hyperthyroidism and diabetes mellitus. An analysis of 70 patients. Arch Intern Med. 1980;140(3):370-3.

Abrams JJ, Grundy SM, Ginsberg H. Cholesterol metabolism in hypothyroidism and hyperthyroidism in man. J Lipid Res. 1981;22(2):323-38.

Perros P, McCrimmon RJ, Shaw G, Frier BM. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet Med. 1995;12(7):622-7.

Gray RS, Irvine WJ, Toft AD, Seth J, Cameron EHD, Clarke BF. Unrecognized thyroid failure in diabetes mellitus. J Clin Lab Immunol. 1979;2:221-4.

Feely J, Isles TE. Screening for thyroid dysfunction in diabetics. Br Med J. 1979;1(6179):1678.

International Diabetes Federation. Diabetes atlas. In: IDF, eds. An Atlas. 6th ed. Belgium: IDF; 2013: 34.

Ahuja M. Epidemiological studies on diabetes mellitus in India. In: Ahuja M, eds. Epidemiology of Diabetes in Developing Countries. 1st ed. New Delhi: Interprint; 1979: 29-38.

Verma NP, Mehta SP, Madhu S, Mather HM, Keen H. Prevalence of known diabetes in an urban Indian environment: the Darya Ganj diabetes survey. Br Med J (Clin Res Ed). 1986;293:423-4.

Ramachandran A, Snehalatha C, Dharmaraj D, Viswanathan M. Prevalence of glucose intolerance in Asian Indians: urban-rural difference and significance of upper body adiposity. Diabetes Care. 1992;15:1348-55.

Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001;44:1094-101.

Feely J, Isles TE. Screening for thyroid dysfunction in diabetics. Br Med J. 1678;1(6179):1979.

Sugure DD, McEvoy M, Drury MI. Thyroid disease in diabetics. Postgrad Med J. 1999;58(685):680-4.

Shah SN. Thyroid disease in diabetes mellitus. J Assoc Physicians India. 1998:32(12):1057-9.

Akbar DH, Ahmed MM, Al-Mughales J. Thyroid dysfunction and thyroid autoimmunity in Saudi type 2 diabetics. Acta Diabetologica. 2006;43(1):14-8.

Radetti G, Paganini C, Gentili L, Bernasconi S, Betterle C, Borkenstein M, et al. Frequency of Hashimoto’s thyroiditis in children with type 1 diabetes mellitus. Acta Diabetologica. 1995;32(2):121-4.

Cátia Cristina Silva Sousa Vergara Palma, Marco Pavesi, Verônica Guedes Nogueira, Eliete Leão Silva Clemente, Maria de Fátima Bevilacqua Motta Pereira Vasconcellos, Luiz Carlos Pereira, Júnior, et al. Prevalence of thyroid dysfunction in patients with diabetes mellitus. Diabetol Metab Syndr. 2013;5:58.

Ramachandran A, Snehalatha C, Kapur A, Vijay V, Mohan V, Das AK, et al. High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia. 2001;44(9):1094-101.

Mohan V, Deepa M, Anjana RM, Lanthorn H, Deepa R. Incidence of diabetes and pre - diabetes in a selected urban south Indian population (CUPS-19). J Assoc Physicians India. 2008;56:152-7.

Ghanshyam Palamaner Subash Shantha, Anita A. Kumar, Vijay Jeyachandran, Deepan Rajamanickam, K. Rajkumar, Shihas Salim, et al. Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross–sectional study from South India. Thyroid Res. 2009;2:2.

Uppal V, Vij C, Bedi GK, Vij A, Banerjee BD. Thyroid disorders in patients of type 2 diabetes mellitus. Indian J Clin Biochem. 2013 Oct-Dec;28(4):336-41.

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

Schlienger JL, Anceau A, Chabrier G, North ML, Stephan F. Effect of diabetic control on the level of circulating thyroid hormones. Diabetologia. 1982;22:486-8./// Bartalena L, Cossu E, Grasso L, Velluzzi F, Loviselli A, Cirillo R, et al. Relationship between nocturnal serum thyrotropin peak and metabolic control in diabetic patients. J Clin Endocrinol Metab. 1993;76(4):983-7.

Ganz K, Kozak GP. Diabetes mellitus and primary hypothyroidism. Arch Intern Med. 1974;134:430-2.

Hecht A, Gershberg H. Diabetes mellitus and primary hypothyroidism. Metabolism. 1968;17:108-13.

Perros P, McCrimmon RJ, Shaw G, Frier BM. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet Med. 1995;12:622-7.

Hage M, Zantout M, Azar S. Thyroid disorders and diabetes mellitus. J Thyroid Res. 2011;2011:439463.

Shantha GP1, Kumar AA, Jeyachandran V, Rajamanickam D, Rajkumar K, Salim S, et al. Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross-sectional study from South India. Thyroid Res. 2009;2:2.

Toteja GS, Singh P, Dhillon BS, Saxena BN. Iodine deficiency disorders in 15 districts of India. Indian J Pediatr. 2004;71(1):25-8.

Udiong CEJ, Udoh AE, Etukudoh ME. Evaluation of thyroid function in diabetes mellitus in Calabar, Nigeria. Indian J Clin Biochem. 2007;22(2):74-8.

Pimenta WP, Mazeto GM, Callegaro CF, Shibata SA, Marins LV, Yamashita S, et al. Thyroid disorders in diabetic patients. Arq Bras Endocrinol Metabol. 2005;49:234-40.

Hector-Eloy Tamez-Perez, Esteban Martı´nez, Dania L Quintanilla-Flores, Alejandra L Tamez-Peña, Hugo Gutiérrez-Hermosillo, Enrique Díaz de León-González. The rate of diagnosed primary hypothyroidism in diabetic patients is greater than in the non-diabetic population. An observational study. Med Clin (Barc). 2011;1:1-4.

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

Suzuki J, Nanno M, Gemma R, Tanaka I, Taminato T, Yoshimi T. The mechanism of thyroid hormone abnormalities in patients with diabetes mellitus. Nippon Niabunpi Gakki Zasshi. 1994;7(4):465-70.

Celani MF, Bonati ME, Stucci N. Prevalence of abnormal thyrotropin concentrations measured by a sensitive assay in patients with type 2 diabetes mellitus. Diabetes Res. 1994;27(1):15-25.

Henry M. Kronenberg. Anti TPO positivity. In: Shlomo Melmed, Kenneth S. Polonsky, P. Reed Larsen, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia: Saunders; 2008: 2011, Table 10-14.

Perros P. McCrimmon RJ, Shaw G, Frier BM. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet Med. 1995;12(7):622-7.

Papazafiropoulou A. Prevalence of thyroid dysfunction among Greek type 2 diabetic patients attending an outpatient clinic. J Clin Med Res. 2010;2(2):75-8.

Neves C, Alves M, Medina JL, Delgado JL. Thyroid diseases, dyslipidemia and cardiovascular pathology. Rev Port Cardiol. 2008;27:1211-36.

Duntas LH, Orgiazzi J, Barbant G. The interface between thyroid and diabetes mellitus. Clin Endocrinol. 2011;75:1-9.

Downloads

Published

2015-06-28

Issue

Section

Original Research Articles