Clinical study on prevalence of thyroid dysfunction in newly diagnosed type ii dm, with special reference to obesity

Introduction:- Diabetes Mellitus(DM) is one of the major public health issues facing the world in 21st century.425 million people have DM in the world out of which 72 million are in India, and by 2045 this will rise to 123.5million by 2040.DM is an endocrine disorder so it is prone to affect other endocrine functions, one of which is thyroid function.DM influences thyroid dysfunction in two sites, first at level of hypothalamus by controlling TSH release and second at peripheral tissues by converting T4 to T3.Diagnosis of thyroid dysfunction in DM patients based solely on clinical manifestations can be difficult. The present study was therefore undertaken to study prevalence of thyroid dysfunction in Newly Detected Type II DM patients & to study correlation between thyroid profile, HbA1c and BMI.
Materials & Methods:-This is prospective descriptive study in which 70 patients with Newly Detected Type II DM in Rajarajeswari Medical College & Hospital underwent thorough history and clinical examination and also investigations like FBS, PPBS, HbA1C, TFT was carried out. Prevalence rate of thyroid dysfunction was studied and their statistical significance with various parameters was obtained using chi square tests.
Results:-Out of the 70 Newly Detected Type 2 DM patients in the study, 18 (25.7%) of them had thyroid dysfunction, out of which10 (14.2%) have subclinical hypothyroidism, 5 (7.14%) had overt hypothyroidism, 2(2.85%) have subclinical hyperthyroidism &1(1.42%) overt hyperthyroidism case, 7 (10%) of them had BMI >23.
Conclusion: This study shows prevalence of abnormal thyroid hormone level (25.7%) among Newly Detected DM subjects. Failure to recognize the presence of abnormal thyroid hormone level at an early stage in Diabetes Mellitus may be a primary cause of poor management often encountered in some treated diabetics. Therefore screening for thyroid disease among patients with Diabetes Mellitus should be routinely performed to rule out possible aggravation of risk factors such as Hypertension and dyslipidemia, which can lead to Cardiovascular Disease risk in such patients.