Thyroid dysfunction in patients with diabetes: clinical implications and screening strategies

作者：Rakesh Uppara Kadiyala, R. Peter, Onyebuchi E Okosieme · 发表于：International Journal of Clinical Practice · 年份：2010 · DOI：10.1111/j.1742-1241.2010.02376.x · 被引用次数：224 · 研究领域：Thyroid Disorders and Treatments、Thyroid Cancer Diagnosis and Treatment、Vitamin D Research Studies

BACKGROUND: Patients with diabetes mellitus are at an increased risk of thyroid disease. The frequency of thyroid dysfunction in diabetic patients is higher than that of the general population and up to a third of patients with type-1 diabetes (T1DM) ultimately develop thyroid dysfunction. Unrecognised thyroid dysfunction may impair metabolic control and add to cardiovascular disease risk in diabetic patients. AIMS: Our aims were to review the current literature on the association between thyroid dysfunction and diabetes mellitus, to highlight relevant clinical implications, and to examine present thyroid disease screening strategies in routine diabetes care. RESULTS: The pleiotropic effects of thyroid hormones on various metabolic processes are now better understood. Uncontrolled hyperthyroidism in diabetic patients may trigger hyperglycaemic emergencies while recurrent hypoglycaemic episodes have been reported in diabetic patients with hypothyroidism. Furthermore, thyroid dysfunction may amplify cardiovascular disease risk in diabetic patients through inter-relationships with dyslipidaemia, insulin resistance and vascular endothelial dysfunction. However, the significance of subclinical degrees of thyroid dysfunction remains to be clarified. While these developments have implications for diabetic patients a consensus is yet to be reached on optimal thyroid screening strategies in diabetes management. CONCLUSIONS: The increased frequency of thyroid dysfunction in diabetic pa...