Abnormalities of thyroid function in children with newly diagnosed type 1 diabetes mellitus: are transient or permanent?

Abstract

Aim: In this study, we aimed to determine the incidence and short term outcome of abnormal thyroid functions in children with newly diagnosed type 1 diabetes mellitus.

Materials and Methods: Fourty-two patients with Type 1 diabetes mellitus who were diagnosed and observed in our department of pediatrics between 2001-2006 were retrospectively evaluated. The thyroid function tests of the patients were measured within four and a half days of the initial diagnosis of diabetes and at least one follow-up test median on day 180 after diagnosis.

Results: Twenty-two (52.4%) of the patients were female and 20 (47.6%) were male. Mean age of the patients was 9.4 (+/- 3.6) years. Twenty-three patients (54.8%) were diagnosed as diabetic ketoacidosis, 15 (35.7%) as ketosis and 4 (9.5%) as hyperglycemia at the time of initial presentation. Thyroid functions were normal in 26 (61.9%) subjects. Thyroid function tests were abnormal in 16 (38.1%) subjects of whom 12 (75.0%) had biochemical findings compatible with sick euthyroid syndrome and of these 10 (83.3%) had diabetic ketoacidosis. All of these abnormalities were transient and thyroid function tests all returned to normal except for one patient. Antithyroid antibodies were positive in 7 (16.7%) subjects 2 (10.5%) with ketosis or hyperglycemia and 5 (21.7%) diabetic ketoacidosis. Thyroid function tests were abnormal in 6 (14.3.1%) subjects at follow-up. Thyroid disfunction rate decrased the 38.1% to 14.3% at the follow-up.

Conclusion: This retrospective study revealed that abnormalities in thyroid function tests in subjects with newly diagnosed Type 1 diabetes mellitus were frequent and mostly transient. For this reason, in the absence of any clinical situation suggesting a thyroid disorder, we think it would be better to assess thyroid function tests at least one mouth after theinitial diagnosis of diabetes.