Close relationship of thyroid dysfunction and diabetes

[diogenes]

People may find this paper of interest, linking thyroid function and diabetes.

Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders

Bernadette Biondi, George J. Kahaly, and R. Paul Robertson

Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy;

Department of Medicine I, Johannes Gutenberg University Medical Center, 55101 Mainz, Germany;

Department of Medicine, Division of Endocrinology and Metabolism, University of Washington School of Medicine, Seattle, Washington 98195; and

Department of Pharmacology, University of Washington, Seattle, Washington 98195

ABSTRACT

Thyroid dysfunction and diabetes mellitus are closely linked. Several studies have documented the increased prevalence of thyroid disorders in patients with diabetes mellitus and vice versa.

.This review critically discusses the different underlying mechanisms linking type 1 and 2 diabetes and thyroid dysfunction to demonstrate that the association of these two common disorders is unlikely a simple coincidence. We assess the current state of knowledge on the central and peripheral control of thyroid hormone on food intake and glucose and lipid metabolism in target tissues (such as liver, white and brown adipose tissue, pancreatic

b cells, and skeletal muscle) to explain the mechanism linking overt and subclinical hypothyroidism to type 2 diabetes and metabolic syndrome. We also elucidate the common susceptibility genes and the pathogenetic mechanisms contributing to the autoimmune mechanism involved in the onset of type 1 diabetes mellitus and autoimmune thyroid disorders. An untreated thyroid dysfunction can impair the metabolic control of diabetic patients, and this association can have important repercussions on the outcome of both of these disorders. Therefore, we offer recommendations for the diagnosis, management, and screening of thyroid disorders in patients with diabetes mellitus, including the treatment of diabetic patients planning a pregnancy. We also discuss the major causes of failure to achieve an optimal management of thyroid dysfunction in diabetic patients and provide recommendations for assessing and treating these disorders during therapy with antidiabetic drugs. An algorithm for a correct approach of these disorders when linked is also provided.

Endocrine Reviews 40: 789- 824, 201

doi/1.1210/er.2018-00163

[Gcart]

I was diagnosed with type 2 diabetes about 10/12years ago . I am not typical as I’m underweight and have been all my life, Plus always active, a keen walker and sailor I never needed and meds and was always diet controlled . However I suffered often from hypo episodes that they stated I couldn’t possibly experience !!

They were easy enough to treat with glucose tablets followed by a sensible snack .

2016 I had my thyroid removed due to cancer following which my ?diabetes settled down .I stopped having these awful episodes of hypo which caught me out sometimes if away from home .

I am now discharged from 6 monthly checkups as my bloods are now normal !

As far I I know my thyroid levels had never been brought to my attention so I assume either not checked or apparently normal!

Me thinks there was a connection ’

[Tythrop]

Given that NHS main focus these days is prevention /saving money ,maybe this piece of research could be used to get them to look again at misdiagnosis of people with thyroid disease who they say are not ill......like my mum said " a stitch in time saves nine'

[Charlie-Farley]

Hi Diogenes, thank you so much.

This is interesting especially as so many Endos are diabetes specialists. Perhaps they might buck up and take an interest in thyroid issues eventually. So good to know about.

[RedSonja]

Yes I'm in the prediabetes lane, which was a shock but due to chronic fatigue have not been active for years. I think there is a link. Same with liver problems

[LindaC]

Most interesting, thank you.

[Knittingcat123]

Thank you for posting, very interesting.Is it possible to read the whole paper?

[Jazzw in reply to Knittingcat123]

I think this is the one ncbi.nlm.nih.gov/pmc/articl...

[helvella Administrator Thyroid UK]

Many years ago, when first getting involved with thyroid issues, one member of a forum frequently pointed out how diabetes and hypothyroidism overlap in many ways. Seeing a paper which recognises the need to view them together would have pleased him.

[RedSonja]

Was just reading the Nice Guidlines link by SlowDragon on another thread and interestingly here it says:

1.2.2 Offer tests for thyroid dysfunction to adults, children and young people with:

type 1 diabetes or other autoimmune diseases, or

new-onset atrial fibrillation.

So it's already within guidelines that are being ignored or overlooked due to ignorance or other factors. But there is official awareness of a link.