Thyroid function at diagnosis of type I diabetes

Arch Dis Child. 2011 Aug;96(8):777-9. doi: 10.1136/adc.2009.168799. Epub 2010 Jun 24.

Abstract

Background: National guidelines recommend that thyroid function is assessed at diagnosis of type I diabetes (TIDM) and annually thereafter. This paper reports an audit of thyroid surveillance in accordance with this guideline.

Patients: 110 patients (66 males), median age 11.3 (1.2-15.7) years at diagnosis of TIDM, were monitored for 2.3 (0.7-4.2) years.

Results: 21/110 (19.0%) patients had abnormal thyroid function at diagnosis of TIDM. Of these, 16 had normal thyroid function on reassessment after 45 (3-540) days. Abnormalities of thyroid function occurred more commonly in children with diabetic ketoacidosis (DKA) than those who did not have DKA (9/29, 31.0% vs 12/81, 14.8%, p<0.025). At the end of the observation period, five (4.5%) patients had minor abnormalities of thyroid function not requiring treatment and three (2.7%) were treated.

Conclusions: Transient abnormalities of thyroid function are common at diagnosis of TIDM, and therefore, thyroid hormones should not be measured at this time.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / diagnosis
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetic Ketoacidosis / complications
  • Diabetic Ketoacidosis / physiopathology
  • Female
  • Follow-Up Studies
  • Guideline Adherence
  • Humans
  • Infant
  • Male
  • Population Surveillance / methods
  • Practice Guidelines as Topic
  • Thyroid Function Tests / methods
  • Thyroid Gland / physiopathology*
  • Thyroiditis, Autoimmune / complications
  • Thyroiditis, Autoimmune / diagnosis
  • Thyrotropin / blood

Substances

  • Thyrotropin