Prevalence of thyroid dysfunction in ambulant patients with Type 2 diabetes attending diabetes clinics at Kenyatta national hospital
Abstract
Thyroid disease and Diabetes are two common endocrinopathies found in the general population.
Thyroid disease is a pathological state which can adversely affect Diabetes control and
contribute to negative patient outcomes. Hyperthyroidism contributes to hyperglycemia while
hypothyroidism contributes to episodes of hypoglycemia. This not only impedes management of
Type 2 Diabetes but also worsens metabolic control. However, uncontrolled diabetes on the
other hand has been shown to impair TSH response to TRH which normalizes with improvement
in glycemic control
Objectives
To determine the prevalence and patterns of thyroid dysfunction in patients with Type 2 Diabetes
Mellitus.
Methodology
This was a cross-sectional descriptive survey of participants who were over the age of 30 years
selected from patients with type 2 Diabetes attending outpatient diabetes clinics. Systematic
random sampling was done on patients meeting the inclusion criteria.A sample size of 180 was
obtained. Consenting participants’ had their demographic data and medical history collected by
use of structured pre-tested questionnaires and a physical examination was done thereafter. This
was followed by drawing of venous blood samples for assessment of, i.e. TSH & fT4. Assays for
thyroid hormones were done using specific antibodies and enzyme markers for specific thyroid
hormones using Enzyme Linked Immuno Sorbent Assay technology. (ELISA)
Results
In this study, majority of the patients were female (62.4%), with a mean age of 59 years and had
a mean duration of 9.5 years with diabetes mellitus. Those with a previous diagnosis of thyroid
dysfunction were about 10.6% and 22.7% had a positive family history of thyroid dysfunction.
The prevalence of thyroid dysfunction in patients with type 2 Diabetes was found to be 61%, of
which subclinical hypothyroidism was the most predominant type at 58%. No patient was found
to have evidence of overt hyperthyroidism.
Conclusion
The prevalence of thyroid dysfunction among patients with type 2 Diabetes is high, particularly
sub clinical hypothyroidism. The clinical significance of this thyroid status on metabolic control
and outcomes need further evaluation
Citation
Master of medicine in internal medicinePublisher
University of Nairobi