Thyroid Dysfunction in Patients with Uncontrolled Type 2 Diabetes Mellitus

Abstract

Background: Diabetes mellitus, particularly type 2, and thyroid dysfunction are the most common endocrine disorders. In addition,thyroid dysfunction is associated with poor glycemic control, and there is increased incidence of thyroid dysfunction in type 2 diabetics.Objectives: This study had been designed to find the frequency of thyroid dysfunction in patients with uncontrolled type 2 diabetes mellitus,the frequency of different types of thyroid dysfunction in this group of patients, the effect of having thyroid dysfunction on the glycemiccontrol, and the glycemic control in patients with well‑treated thyroid dysfunction. Patients and Methods: This study is a cross‑sectionalstudy which included 500 patients with type 2 diabetes mellitus who had been randomly selected from the patients attending the NationalCenter for Diabetes/Al‑Mustansiriya University and the outpatient clinic of Al‑Yarmouk Teaching Hospital during the period between August1, 2016, and July 31, 2017. All of the patients underwent a full history and physical examination, in addition, all of them were sent for randomplasma glucose, glycated hemoglobin, and “thyroid‑stimulating hormone.” Results: This study showed that 364 patients(72.8% of the sample)had poor glycemic control. Thyroid dysfunction was diagnosed in 67 patients (18.4% of those with poor glycemic control), 43.28% of themwere known to have thyroid dysfunction, and the rest of them were discovered to have thyroid dysfunction during the study. Hypothyroidism, including both subclinical and primary types, was diagnosed in 26 patients. Statistical analysis showed that significant association between poor glycemic control and thyroid dysfunction calculated Chi‑square was 10.67 and P = 0.001086. Conclusions: This study showed thatthyroid disorders are not uncommon in patients with uncontrolled type 2 diabetes mellitus. Hypothyroidism is the most common type ofthyroid dysfunction and having thyroid dysfunction whether in the form of hypo or hyperfunction is associated with poor glycemic control and controlling thyroid state result in better glycemic control.