Lack of Association between Poor Glycemic Control in T2DM and Subclinical Hypothyroidism

Abstract

Background. Hypothyroidism is a highly prevalent and multifactorial disorder and has been implicated in the causation of dyslipidemia, dermatological diseases, atherosclerosis, and myocardial dysfunction, as well as endothelial dysfunction. The relationship between subclinical hypothyroidism and type 2 diabetes mellitus is not well established. In the present study, we attempt to find out the prevalence of subclinical hypothyroidism in type 2 diabetes mellitus and its association with glycemic control. Materials and Methods. This was an observational study in which 205 consecutive patients of T2DM visiting the outpatient department of medicine were recruited. Serum TSH, free thyroxine, free triiodothyronine, and lipid profile, as well as HbA1c assays, were done in the study participants, and they were categorized into three groups by HbA1c: <7%, 7–9%, and >9%. Results. There is a high prevalence of subclinical hypothyroidism in type 2 DM patients. Mean HbA1c in diabetics without SCH was 7.89%, whereas it was 8.33% in diabetics with SCH. This difference was statistically not significant. TSH was not found to be significantly associated with HbA1c. Conclusion. High prevalence of SCH in T2DM patients suggests that there is a need for regular follow-up to check the progression of SCH to overt hypothyroidism. High serum TSH is not a predictor of poor glycemic control.

The impact of diabetes and subclinical hypothyroidism association with coronary artery calcium: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

“…Sharma and cols. (2020) reported that patients with diabetes and subclinical hypothyroidism have similar glycemic control as patients with only diabetes ( 38 ), and Mehalingam and cols. (2020) reported that patients with both diseases did not present more severe complications of diabetes compared to patients with only diabetes ( 39 ).…”

Diabetes, disfunção tireoidiana subclínica e aterosclerose subclínica medida pelo escore de cálcio e a espessura de íntima-média das carótidas: resultados do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)

“…Os autores pontuaram que esse efeito foi mais forte em indivíduos com 65 anos ou mais quando comparado aos mais jovens (Chen et al, 2007;Cho et al, 2016;Elgazar et al;. Entretanto, em contraste com os estudos anteriores, Sharma et al (2020) relatou em uma pequena amostra de pacientes com diabetes que aqueles que apresentavam diabetes e hipotireoidismo subclínico tinham um controle glicêmico similar aos que apresentavam apenas diabetes (Sharma et al, 2020) e a análise de Mehalingam et al (2020) em 331 pacientes com diabetes mostrou que a presença do hipotireoidismo subclínico não foi associado com complicações mais graves do diabetes em pacientes com ambas as doenças (Mehalingam et al, 2020).…”