ESPE Abstracts (2015) 84 P-1-37

Hyperthyroidism in 276 Children and Adolescents with Type 1 Diabetes from Germany and Austria

Axel Dosta, Tilman R Rohrerb, Elke Fröhlich-Reitererc, Esther Bollowd, Beate Kargese, Andreas Böckmannf, Johannes Hamanng & Reinhard W Holld

aDepartment of Pediatrics, University Hospital Jena, Jena, Germany; bDepartment of Pediatrics, Saarland University Medical Center, Homburg, Germany; cDepartment of Pediatrics, Medical University of Graz, Graz, Austria; dInstitute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany; eMedical Faculty, Division of Endocrinology and Diabetes, German Center for Diabetes Research (DZD), RWTH Aachen University, Aachen, Germany; fDepartment of Pediatrics, Konstanz Hospital, Konstanz, Germany; gDepartment of Pediatrics, St. Marien Hospital Landshut, Landshut, Germany; hInstitute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany

Background and aims: Little is known about the incidence and clinical consequences of hyperthyroidism in paediatric patients with type 1 diabetes mellitus (T1DM).

Methods: We analysed the DPV database to investigate the rate of hyperthyroidism in paediatric T1DM patients, its impact on metabolic control, and potential associations with other autoimmune diseases.

Results: Hyperthyroidism was found in 276/60,456 patients (0.46%) and was associated with younger age, shorter diabetes duration, female sex, and reduced body mass index. Diabetic ketoacidosis (DKA) and hypoglycaemia were more frequent in T1DM with comorbid hyperthyroidism, while long-term metabolic control (HbA1c) was similar in both groups. Absolute blood pressure and arterial hypertension rate were elevated in the hyperthyroid patients. Rates of microalbuminuria and diabetic retinopathy were not different. Thyroid-specific antibodies (TPO, TG, TR) were associated with hyperthyroidism. Thyroid volume and rates of cysts and nodules were higher and echogenicity was decreased.

Conclusion: Prevalence of hyperthyroidism is low in diabetic children with T1DM but increased compared to children <18 years without diabetes. Hyperthyroidism is primarily associated with acute diabetes complications (DKA and hypoglycaemia) and affects blood pressure regulation. Long-term metabolic control or insulin requirement were not different.

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