Issue 151 Item 8 Association Between Autoimmune Thyroid Dysfunction And Type 1 D

Study confirms need for regular thyroid dysfunction screening. Previous cross-sectional studies have reported a two- to three-fold higher risk of thyroid dysfunction in type 1 diabetics compared with the general population, explain investigators. However, longitudinal studies have been lacking.

The investigators, from the Divisions of Endocrinology and Preventive Medicine at the University of Tennessee Health Science Center in Memphis, United States, studied 26 men and 32 women who enrolled in the centre’s Diabetes Control and Complications Trial in 1983. The men and women were prospectively followed for 18 years.

Results showed that 18 patients had hypothyroidism and 1 patient experienced transient hyperthyroidism. Two subjects developed hypothyroidism before diabetes and were excluded from the analysis.

Diabetes was diagnosed at a mean age of 19 ± 2 years and hypothyroidism at 29 ± 3 years. Forty-one percent of the female patients developed hypothyroidism compared with 19% of the male patients.

Hypothyroidism was also more common in patients with thyroid peroxidase antibodies. Patients who were positive for these antibodies were 17.91 times as likely to develop hypothyroidism than their negative counterparts.

The investigators suggest that patients with type 1 diabetes, particularly those positive for thyroid peroxidase antibodies, should undergo annual thyroid-stimulating hormone measurements to detect asymptomatic thyroid dysfunction. Diabetes Care 2003;26:4:1181-1185

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FACT: According to a new study by the U.S. Department of Health and Human Services, the nation now spends $13,243 on each person with diabetes, compared to $2,560 for people without the disease. This represents a direct medical cost of $91.8 billion. CDC