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Review
. 2019 Dec;10(6):2035-2044.
doi: 10.1007/s13300-019-00700-4. Epub 2019 Oct 3.

Thyroid Dysfunction and Type 2 Diabetes Mellitus: Screening Strategies and Implications for Management

Sanjay Kalra  1 , Sameer Aggarwal  2 , Deepak Khandelwal  3
Affiliations
Review

Thyroid Dysfunction and Type 2 Diabetes Mellitus: Screening Strategies and Implications for Management

Sanjay Kalra et al. Diabetes Ther. 2019 Dec.

Abstract

Diabetes mellitus (DM) and thyroid dysfunction (TD) often tend to coexist in patients. Both hypothyroidism and hyperthyroidism are more common in type 2 diabetes mellitus (T2DM) patients than in their nondiabetic counterparts. Current guidelines are neither clear nor specific about the frequency of thyroid function monitoring in T2DM patients. Circulating thyroid hormones affect several different organs and cells, have a major impact on glucose, lipid, and protein metabolism, and can worsen glycaemic control in T2DM. Hyperthyroidism and thyrotoxicosis can worsen subclinical DM and cause hyperglycaemia in T2DM patients, increasing the risk of diabetic complications. T2DM reduces thyroid-stimulating hormone levels and impairs the conversion of thyroxine (T4) to triiodothyronine (T3) in the peripheral tissues. Poorly managed T2DM can lead to insulin resistance and hyperinsulinaemia, which causes thyroid tissue proliferation and increases nodule formation and goitre size. In addition, while metformin can be beneficial in both T2DM and TD patients, other antidiabetics such as sulfonylureas, pioglitazone, and thiazolidinediones can negatively impact TD. Antithyroid drugs such as methimazole can impair glycaemic control in T2DM patients. Thyrovigilance in T2DM patients and diabetovigilance in TD patients may therefore be necessary to facilitate individualized care and management.Funding: Abbott India Ltd.

Keywords: Hyperthyroidism; Hypothyroidism; Insulin resistance; Thyroid dysfunction; Type 2 diabetes mellitus.

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Figures

Fig. 1
Fig. 1
Simplified algorithm for thyroid screening in diabetes (modified from Kadiyala et al. [62]). T1DM type 1 diabetes mellitus, T2DM type 2 diabetes melliltus, TSH thyroid-stimulating hormone, anti-TPO thyroid peroxidase antibody
See this image and copyright information in PMC

References

    1. Nederstigt C, Corssmit EPM, de Koning EJP, Dekkers OM. Incidence and prevalence of thyroid dysfunction in type 1 diabetes. J Diabetes Complicat. 2016;30:420–425. - PubMed
    1. Gu Y, Li H, Bao X, Zhang Q, Liu L, Meng G, et al. The relationship between thyroid function and the prevalence of type 2 diabetes mellitus in euthyroid subjects. J Clin Endocrinol Metab. 2017;102:434–442. - PubMed
    1. International Diabetes Federation. IDF Diabetes Atlas. 2017. https://www.idf.org/aboutdiabetes/what-is-diabetes/facts-figures.html. Accessed 11 Feb 2019.
    1. Garmendia Madariaga A, Santos Palacios S, Guillén-Grima F, Galofré JC. The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis. J Clin Endocrinol Metab. 2014;99:923–931. - PubMed
    1. Centeno Maxzud M, Gómez Rasjido L, Fregenal M, Arias Calafiore F, Córdoba Lanus M, D’Urso M, et al. Prevalence of thyroid dysfunction in patients with type 2 diabetes mellitus. Medicina (Mex). 2016;76:355–358. - PubMed

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