TYPE 2 DIABETES AND THYROID DISEASE: SEARCH FOR COMMON MECHANISMS
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2020.1.11006Keywords:
type 2 diabetes, thyroid disease, hypothyroidism, goiterAbstract
Diabetes mellitus and thyroid disease are the two most common endocrine disorders in clinical practice, as metabolic and thyroid hormone disorders can affect each other.
The aim of the study – to analyze the literature on the prevalence of type 2 diabetes, its comorbidity with thyroid diseases, and the main pathogenesis pathways, provided that they are combined.
Materials and Methods. The study looked at scientific publications over the last decade that are available on the Internet, with the key words "type 2 diabetes," "thyroid disease," "comorbidity," "pathogenesis."
Results. The relationship between diabetes and thyroid dysfunction is characterized by a complex interaction. A number of studies have reported the prevalence of thyroid dysfunction among patients with diabetes ranging from 2.2 to 17 %. However, several studies have shown a very high prevalence of thyroid dysfunction in type 2 diabetes, as 31 % and 46.5 %, respectively. High or low levels of thyroid hormones are associated with peripheral insulin resistance. T3 has been shown to play a role in protecting pancreatic β-cells from apoptosis. Diabetes mellitus impairs thyroid function by affecting both the hypothalamic control of TSH production and the transformation of T4 to T3 in peripheral tissue. Therefore, patients with diabetes should be screened for thyroid dysfunction. Cross-sectional studies have shown that female sex, a family history of thyroid disease and smoking may increase the risk of hypothyroidism in patients with diabetes. Insulin resistance and compensatory hyperinsulinemia may be involved in thyroid cell proliferation and thyroid nodule formation.
Conclusions. The relationship between thyroid function and diabetes mellitus type 2 is bidirectional and subject to complex interactions. The most common thyroid disorders found in patients with diabetes mellitus are subclinical and clinical hypothyroidism, as well as nodular goiter.
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