Background: Over the recent years there have been more and more cases with DM type 1 and thyroid autoimmune diseases.
Objective: To study course of autoimmune thyroiditis in children and adolescents with DM type 1.
Methods: From 758 children with DM type 1 we identified high risk cohort (thyroid gland palpation and clinical symptoms) and performed thyroid US and TSH, fT4, anti-TPO, anti-TG, and HbA1c testing. Cohort group, 84 patients were followed for 25 years. Treatment with l-thyroxine was administered in cases of enlarged gland and/or TSH elevation (tested twice, with elevation above 4.5 mU/l). Diabetes compensatory markers were compared with control group of same age with DM type 1 and no autoimmune thyroiditis.
Results: Autoimmune thyroiditis was found in 38 cases: girls 22 (57.9%), boys 16 (42.1%). Prevalence of thyroiditis in study population was 5 vs 1.2% in general population. Stratification according to age 310 years 15 patients (39.5%), 1118 years 23 patients (60.5%).
US results: Enlarged gland 78.9%, normal volume 15.8%, and decreased volume 5.3%. US changes 94.7% and structural changes 65.8%. Elevated anti-TPO 92.1%, anti-TG 57.8%, both 50% of case. Anti-TPO was high in 1118 years old group (P<0.05). Hypothyreosis was found in 13.2%, subclinical hypothyreosis 26.3%, euthyreosis 57.9%, and hyperthyreosis 2.6%. Fourteen patients received treatment with l-thyroxine. Statistically significant difference was not found between HbA1c level and insulin requirement in study as well as control group.
Conclusion: Autoimmune thyroiditis is more prevalent in DM type 1 patients than in general population of same age. Prevalence increases with age and diabetes duration. Thyroid disease in euthyroid state does not cause worsening of DM.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology