scholarly journals The Frequency of Thyroid Dysfunctions among Patients of Diabetes Mellitus Presenting in Tertiary Care Hospital of a Developing Country

Author(s):  
Rabia Arshad ◽  
Shahzaib Maqbool ◽  
Sara Arshad ◽  
Fatima Rehman ◽  
Muhammad Nadeem ◽  
...  

Aims: Thyroid disease is a pathological state associated significantly with diabetes mellitus (DM) Type 1 and Type 2. As the prevalence of diabetes mellitus is on the rise in our population, so the purposed significance of our study was to evaluate the frequency of thyroid dysfunction in diabetic patients of our local population. Study Design: Cross-sectional study. Place and Duration of Study: This study conducted among patients of diabetes (Type 1 and Type 2) from September 2020 to March 2021 while their visit in Holy family hospital, Rawalpindi, for a routine clinical check-up on an OPD basis. Methodology: A total of 96 patients with diabetes mellitus on regular medication, 20 to 60 years of age, were included. Patients with diabetic ketoacidosis, hyperlipidemia, pregnant females, and those taking medication that can affect thyroid functions (dopamine antagonists, antiepileptics, oral contraceptives, lithium, glucocorticoids) were excluded. A venous blood sample was drawn and sent to the laboratory to analyze thyroid function tests for the presence or absence of any thyroid dysfunction. Data analysis was done through SPSS.v.23. Descriptive statistics and Chi-square analysis was used, and a p-value of ≤ 0.05 was considered significant. Results: The mean age of the patients was 42.97 ± 10.29 years. The majority of the patients, 37.50%, were between 41 to 50 years of age. Out of 96 patients, 61 (63.54%) were male, and 35 (36.46%) were females with a male to female ratio of 1.7:1. The majority of patients, 69 (71.88%), had type II diabetes mellitus. The frequency of thyroid dysfunction found in diabetic patients was 30 (31.25%), with hypothyroidism in 19 (19.79%) and hyperthyroidism in 11 (11.46%) patients. Conclusion: This study deduced that there is a high frequency of thyroid dysfunction in diabetic patients. In the same vein, hypothyroidism was the common thyroid dysfunction associated with diabetes mellitus.

2018 ◽  
Vol 5 (4) ◽  
pp. 822
Author(s):  
K. Shaik Anwar Hussain

Background: There is a complex interrelationship in the co-existence of thyroid dysfunction among diabetic patients and may be related to the development of cardiovascular diseases and other complications of long term metabolic derangements. The prevalence of thyroid dysfunction varies from 10 to 24% among diabetic patients. The objective of the present study was to determine the prevalence of thyroid dysfunction among the patients with diabetes mellitus in a tertiary care hospital at Puducherry, India.Methods: This retrospective study was conducted during June 2018 analysing the records of diabetes patients attending to the diabetes OPD, Department of General Medicine in the past one year and their association with thyroid dysfunction was studied.Results: Among the study participants (n=200), 14.5% (n=29) were Type I diabetics and 85.5% (n=171) were type II Diabetes patients. The prevalence of Thyroid Dysfunction (TD) among the study participants was 28.5% (n=57). The proportion of TD was higher among type 1 DM compared to type 2 (p<0.001).  The prevalence of subclinical hypothyroidism was more (n=7, 24.1%) among type 1DM compared to type II DM patients (p=0.05).Conclusions: There was a higher prevalence of TD among the diabetics. TD was more frequent among type 1 DM compared to Type 2 DM patients and the most frequent TD associated with diabetes was subclinical hypothyroidism.


2021 ◽  
Vol 8 (40) ◽  
pp. 3477-3482
Author(s):  
Prasantha Kumar Thankappan

BACKGROUND It has been noted of the interdependence and impact of diabetes mellitus and thyroid dysfunction on each other. Prevalence of thyroid dysfunction was found to be higher in individuals with diabetes mellitus. Most commonly associated thyroid dysfunction in diabetes was hypothyroidism. Hyperthyroidism can precipitate complications in diabetes mellitus. The purpose of this study was to assess the prevalence of thyroid dysfunction and dyslipidaemia in type 2 diabetes mellitus patients. METHODS This cross-sectional study included a total number of 100 type-2 diabetic patients aged >15 years. All the patients were evaluated for thyroid dysfunction and dyslipidaemia by estimating triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) and lipid profile [total cholesterol (TC), triglycerides (TGA-c), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C)].The correlation of prevalence of thyroid disorder with gender distribution, age distribution, HbA1C, duration of diabetes, family history of thyroid disorder, body mass index (BMI), usage of oral hypoglycaemic agents (OHA’s) and insulin and dyslipidaemia was carried out. The observations and interpretations were recorded and results obtained were statistically analysed. This study was conducted from December 2018 to November 2019 at Government Medical College, Kottayam, Kerala. RESULTS The study revealed a high prevalence (26 %) of thyroid disorders in patients with type 2 diabetes mellitus (T2DM), most common being hypothyroidism (20 %) which was further found to be more in females, patients with uncontrolled diabetes i.e. HbA1C values ≥ 8.7 or patients on OHA and patients with BMI > 25. High prevalence of dyslipidaemia in diabetics (62 %) was observed; of which 51 % had hypertriglyceridaemia, 49 % had decreased HDL-C, 47 % had hyper cholesterolaemia and 43 % had increased LDL-C. Only 30.6 % diabetics with dyslipidaemia had thyroid dysfunction. CONCLUSIONS Screening of thyroid dysfunction should be done in all diabetic patients especially in patients with poor glycaemic control as micro vascular complications were commonly observed in this group of patients with dual endocrine disorders. There is a high prevalence of dyslipidaemia in diabetics. KEYWORDS Diabetes Mellitus, Thyroid Dysfunction, Dyslipidemia


2020 ◽  
Vol 7 (12) ◽  
pp. 1815
Author(s):  
Mausam Jain ◽  
Pramod R. Jha ◽  
Gaurang Patel

Background: Aim was to study prevalence of thyroid dysfunction in type II diabetes mellitus (T2DM) patients.Methods: The present study was a cross sectional observational study, which focused on cases of diabetes mellitus. Study was conducted in Departments of Medicine, SBKS MI & RC, a tertiary care centre for a period of 6 months. All the patients of T2DM were included. Total of 263 patients were enrolled which involved indoor, outpatient and diabetic clinic attending patients. A detailed history taking, clinical examination and relevant investigations (Hb%, Total count, platelet count, serum creatinine, FBS, PP2BS, HbA1C, S.TSH, F.T3 and F.T4). Appropriate statistical analytics were used and important correlations and conclusions were drawn.Results: A study of thyroid dysfunction (TD) in T2DM patients which included 263 diabetic patients, out of them 67 had thyroid dysfunction. Out of these 67 patients 43 were female and 24 were male. This suggests that female was more prone to thyroid dysfunction than males. Out of 67 TD patients, 42 were above the age of 50 year. So, as the age increases the prevalence of TD also increases thyroid dysfunction also depends on the glycaemic control of the patients. Out of 67 patients 22 patients had>8.0 HbA1C level. In our study we found that as the glycaemic control became poorer the prevalence of TD increase in hypothyroid but not in hyperthyroidism.Conclusions: Following conclusions were drawn from this study TD is more common in female than male, more after the age of 50 year, in T2DM patients. Hypothyroidism is more common with poor glycaemic control and long duration of T2DM patients. But for hyperthyroidism data which we evaluated was not significant and further conclusion bigger study is needed.


2012 ◽  
Vol 120 (05) ◽  
pp. 277-281 ◽  
Author(s):  
J. Škrha Jr ◽  
M. Kalousová ◽  
J. Švarcová ◽  
A. Muravská ◽  
J. Kvasnička ◽  
...  

AbstractReceptor for advanced glycation endproducts (RAGE) plays the essential role in the pathogenesis of diabetic vascular complications. The aim of the study was to compare concentration of soluble RAGE and its ligands (EN-RAGE and HMGB1) with different biochemical parameters in Type 1 (T1DM) and Type 2 (T2DM) diabetes mellitus.Total number of 154 persons (45 T1DM, 68 T2DM, 41 controls) was examined and concentrations of sRAGE, EN-RAGE and HMGB1 were measured and compared to diabetes control, albuminuria, cell adhesion molecules and metalloproteinases (MMPs).Mean serum sRAGE concentration was higher in T1DM as compared to controls (1137±532 ng/l vs. 824±309 ng/l, p<0.01). Similarly, EN-RAGE was significantly higher in both diabetic groups (p<0.001) and HMGB1 concentrations were elevated in T2DM patients (p<0.01). Significant relationship was found between MMP9 and HMGB1 and EN-RAGE in diabetic patients. Inverse relationship was observed between MMP2 and MMP9 in both types of diabetic patients (r= − 0.602, p<0.002 and r= − 0.771, p<0.001). Significant positive correlation was found between sRAGE and ICAM-1, VCAM-1 or vWF (p<0.01 to p<0.001).We conclude that serum sRAGE and RAGE ligands concentrations reflect endothelial dysfunction developing in diabetes.


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0049
Author(s):  
William Tucker ◽  
Brandon Morris ◽  
Armin Tarakemeh ◽  
Scott Mullen ◽  
Paul Schroeppel ◽  
...  

Category: Diabetes Introduction/Purpose: Diabetes mellitus (DM) poses a risk for increased rate of complications in many orthopaedic procedures, especially in patients undergoing elective arthroplasty procedures. Treatment of end-stage ankle arthritis includes both arthroplasty and arthrodesis. Current literature provides minimal guidance regarding outcomes of total ankle replacement (TAR) or ankle arthrodesis (AA) in diabetic patients. The authors of this study utilized a large database to compare rates of postoperative complications and reoperations of diabetic patients undergoing surgical management of ankle arthritis to rates seen in non-diabetic patients. Methods: Using the PearlDiver Technologies, Inc. database, Medicare patients diagnosed with ankle arthritis using ICD-9 codes were identified from 2005 to 2014. Patients were then sorted as diabetic or non-diabetic. Diabetic patients were then further stratified into Type 1 diabetes (T1DM) and Type 2 diabetes (T2DM). Type 2 diabetics requiring insulin (T2ID) and not requiring insulin (T2NID) were also isolated. Patients were identified who underwent either AA or TAR utilizing ICD-9 procedure and CPT codes. These groups were evaluated for postoperative complications and reoperation rates. Chi-Squared testing was used to determine significance. Multivariate analysis was performed to determine whether diabetes represents an independent risk factor. Results: 1477 diabetic patients underwent TAR and 5399 underwent AA versus 3900 TAR and 7838 AA in nondiabetics. Diabetics undergoing AA experienced complications at 32.2%, reoperations at 30.8%, and revisions at 18.7% versus 13.3%, 22.3%, and 19.2% respectively in patients without diabetes(P<0.05). In diabetics undergoing TAR, the complication rate was 21.6% and reoperation rates were 16.9% versus 12.5% and 13% respectively in their non-diabetic counterparts(P<0.05). Revision rates were similar. Patients with T1DM had more reoperations and complications in both TAR and AA compared to those with T2DM (P<0.05). In both surgical groups, Patients with T2ID had more complications and reoperations than those with T2NID(P<0.05). Multivariate analysis revealed diabetes as an independent risk factor for complication and reoperation in AA but only complication in TAR(P <0.05). Conclusion: Patients with a diagnosis of diabetes mellitus experienced higher complication and total reoperation rates when undergoing either TAR or AA. T1DM appears to impart a greater risk of surgical complication and repeat surgical intervention than does T2DM. However when insulin is required in T2DM, complication and reoperation rates are similar to those of T1DM. Patient selection for surgical management of end-stage ankle arthritis should incorporate diabetic type and insulin dependency when considering surgical intervention.


2014 ◽  
Vol 6 (3) ◽  
pp. 33-37
Author(s):  
Pranav Kumar Raghuwanshi ◽  
Devendra Pratap Singh Rajput ◽  
Bhupendra Kumar Ratre ◽  
Roopesh Jain ◽  
Narmada Patel ◽  
...  

Background: Diabetes mellitus is a very common endocrinal disorders and incidence of thyroid dysfunction also rising in India and world over. Thyroid hormones directly control insulin secretion and insulin clearance. Diabetes also may affect the thyroid function to variable extent first at the level of hypothalamic control of TSH release and second at peripheral tissue by converting T4 to T3. Aims and Objectives: The present study was carried out aiming to evaluate thyroid dysfunction among type 2 diabetes mellitus patients. Material and Methods: Study included total 80 subjects. Thyroid dysfunction was evaluated by investigating the subjects for Total tri-iodo-thyronine (T3), Total thyroxine (T4) and thyroid stimulating hormone (TSH). Plasma glucose was estimated by- GOD-POD method and Thyroid profile was estimated by- CLIA (chemiluminescence immunoassay) system. Statistical analysis was performed using software statistical package for social sciences (SPSS) version 20, unpaired T test, Pearson’s correlation. Results: In type 2 diabetic patients the prevalence of hypothyroidism and subclinical hypothyroidism was found to be 4(10.00%) and 6(15.00%) respectively, while the prevalence of subclinical hyperthyroidism and hyperthyroidism was found to be 0(0.0%) and 1(2.5%) respectively. In non diabetic healthy subjects the prevalence of hypothyroidism and subclinical hypothyroidism was found to be 1(2.5%) and 3(7.5%) respectively while the prevalence of subclinical hyperthyroidism and hyperthyroidism was found to be 0(0.0%) and 0(0.0%) respectively. Conclusion: The prevalence of thyroid dysfunction was found to be higher in type 2 diabetes mellitus subjects as compared to non-diabetic subjects. DOI: http://dx.doi.org/10.3126/ajms.v6i3.10814Asian Journal of Medical Sciences Vol.6(3) 2015 33-37  


Author(s):  
Abhishek Kamendu ◽  
Ahmad Nadeem Aslami

Background: Diabetes has become a major health challenge all over the world. Previous studies have found that diabetes and thyroid disorders mutually influence each other and both disorders tend to coexist. The aim of this study was to find out prevalence of hypothyroidism and its associated factors in type 2 diabetes mellitus patients.Methods: Consecutive 200 patients with type 2 diabetes mellitus attending outpatient department of medicine in a tertiary care centre in Sasaram, Bihar were evaluated clinically and biochemically. Subclinical hypothyroid and overt hypothyroidism was diagnosed as per standard definitions. The results obtained were statistically analysed by using chi square test and finding odds ratio.Results: Out of 200 patients, 75.5% were euthyroid while 24.5% were hypothyroid. Out of 49 hypothyroid patients, subclinical hypothyroid (SC-Hypo) was present in 41 patients and overt hypothyroid (C-Hypo) was present in only 8 patients. The prevalence of hypothyroidism was found more in males, age ≥60 years, patients with HbA1c value ≥7%, patients with diabetes duration less than 5 years and in hypertensive patients.Conclusions: Thyroid dysfunction screening should be done in all type 2 diabetic patients periodically and appropriate individualized treatments in addition to thyroid function test should be given to diabetes mellitus patients with subclinical hypothyroidism as well.


2019 ◽  
Vol 47 (6) ◽  
pp. 525-534
Author(s):  
E. Yu. Lomakina ◽  
O. V. Taratina ◽  
E. A. Belousova

Background: For a long time there has been a discussion about how chronic pancreatitis (CP) and diabetes mellitus (DM) are related to each other. If a patient has both conditions, should they be viewed as two separate disorders, or one of them is a plausible consequence of the other? If the latter is true, what are pathophysiological mechanisms of DM in CP? Current consensus documents by specialists in pancreatic diseases pay little attention to this issue, and their main statements have low level of evidence. The Russian consensus on the diagnosis and treatment of CP (2016) contains no statements on DM. In the Russian guidelines and consensus documents to be developed, it is necessary to include provisions on the pancreatogenic DM as an independent “other type DM’, with consideration of its pathophysiological mechanisms and clinical particulars.Aim: To characterize the state-of-the-art in pancreatogenic DM, to demonstrate its differences from DM types 1 and 2 from pathogenetic and clinical perspectives.Methods: The review is based on the results of meta-analyses, systematic reviews and main provisions of the existing clinical guidelines and consensus documents available from PubMed and E-library.Results: According to various sources, Type 3c DM, or latent impaired glucose tolerance in CP, can eventually develop in 25 to 80% patients with CP. Impaired glucose tolerance is found in 40 to 60% of patients with acute pancreatitis, with persistent hyperglycemia after acute episode seen in 15 to 18% of the patients. Exocrine pancreatic insufficiency is commonly seen in Type 1 and Type 2 diabetic patients, although the data on its prevalence are highly contradictory indicating a lack of knowledge in the field. Type 3c DM is characterized by its manifestation at later stages of CP, concomitant excretory deficiency of the pancreas, brittle course with proneness to hypoglycemia and no ketoacidosis. The highest risk group includes patients with longstanding CP, previous partial pancreatic resection and patients with early calcifying pancreatitis, mainly of the alcoholic origin. Optimal and rational medical treatment of pancreatogenic DM still remains disputable, while the evidence base of the efficacy and safety of various anti-diabetic agents in this disease is lacking, and no consensus on the issue has been yet reached. General treatment guidelines given in a number of international consensus documents are limited to cautious insulin administration.Conclusion: Pancreatogenic DM differs from Type 1 and Type 2 DM in a number of aspects, namely, mechanisms of hyperglycemia, hormonal profiles, clinical particulars and treatment approaches. Endocrine pancreatic insufficiency in CP is caused by secondary inflammatory injury of the pancreatic islets. The key to specifics of Type 3c DM lies in anatomical and physiological interplay of the exocrine and endocrine compartments of the pancreas. At presents, most provisions on pancreatogenic DM are empirical and seem to be rather declarative, because intrinsic mechanisms of this type of diabetes and moreover its pathogenetically based treatment have been poorly studied. Nevertheless, all patients with CP or other pancreatic diseases should be assessed for pancreatogenic DM.


2001 ◽  
Vol 44 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Eliška Marklová

Practically all types of diabetes mellitus (DM) result from complex interactions of genetic and environmental factors. Multifactorial and polygenic Type 1 DM is strongly influenced by genes controlling the immune system, mainly HLA-DQ and DR. In addition to this, many other predisposition loci, interacting with each other, have some influence on susceptibility to DM. Heterogeneous Type 2 DM, accounting for about 85 % of all diabetic patients, is supposed to be induced by multiple genes defects involved in insulin action and/or insulin secretion. Other genetically influenced traits like obesity and hyperlipidemia are strongly associated with the Type 2. The group called Other specific types of DM include monogenic forms MODY 1-5 and many various subtypes of the disease, where the specific gene mutations have been identified. Both genetic and intrauterine environmental influences are likely to contribute to the abnormalities defined as Gestational DM.


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