ESPE Abstracts

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 2–5 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 3–10 years – 15 patients (39.5%), 11–18 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 11–18 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.