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• Adult onset diabetes with hypo to hyperthyroidism
  GR Sridhar
  Published on: 24 November 1999

• Published on: 24 November 1999

  Adult onset diabetes with hypo to hyperthyroidism

  • GR Sridhar, Endocrinologist

  A 39-year diabetic, for six months had primary hypothyroidism three years ago, normalized with thyroxine. Seventeen months later he was hyperthyroid, reversed by carbimazole (30 mg/d) and recurred on stopping. His thyroid microsomal antibody was positive (1:25,600).

  Thyroid disorders were present in 6.9% adult diabetics in Edinburgh (1). Type 2 diabetes was seen in 7.6% patients with Grave’s thyrotoxicosis in Ja...

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  A 39-year diabetic, for six months had primary hypothyroidism three years ago, normalized with thyroxine. Seventeen months later he was hyperthyroid, reversed by carbimazole (30 mg/d) and recurred on stopping. His thyroid microsomal antibody was positive (1:25,600).

  Thyroid disorders were present in 6.9% adult diabetics in Edinburgh (1). Type 2 diabetes was seen in 7.6% patients with Grave’s thyrotoxicosis in Japan (2).

  In our database of endocrine diseases, among 8225 diabetics 73 had thyroid disorders (0.89%): 65 had hypothyroidism (65/73; 89%), and eight thyrotoxicosis (8/73;11%). Out of 1777 persons with thyroid disorders 31 had diabetes mellitus (1.74%; 16 had hypothyroidism (51.6%), eight thyrotoxicosis (25.8%) and seven other conditions.)

  Consanguinity (2) , increasing age, when thyroid diseases are common, and some type 2 diabetic patients being slow-onset type 1 diabetic were implicated (3).

  Hypothyroidism going into hyperthyroidism is unusual. It is likely due to the switch of blocking antibodies replaced by stimulatory antibodies to TSH and resultant hyperthyroidism (5).

  References:

  1. Perros P, McCrimmon RJ, Shaw G, Frier BM. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. .Diabetic Med 1995;12:622-7

  2. Komiya I, Takasu N, Yamada T, Ohara N, Ootsuka H, Ota M, Fukushima H, Sekikawa A, Tominaga M, Sasaki H. Studies on the association of NIDDM in Japanese patients with hyperthyroid Grave’s disease. Horm Res 1992;38:264-8

  3. Jaworski MA, Slater JD, Severini A, Henning KR, Mansour G, Mehta JG, Jeske R, Schlaut J, Pak CY, Yoon JW. Unusual clustering of diseases in a Canadian Old Colony (Chortitza) Mennonite kindred and community. CMAJ 1988;138:1017-25

  4. McKenzie JM, Zakarija M. Antibodies in autoimmune thyroid disease. In Braverman LE, Utiger RD (eds). Werner and

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  Conflict of Interest:
  None declared.

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