ESPE Abstracts (2015) 84 P-3-741

Low fT3 Syndrome due to Metabolic Acidosis/Ketoacidosis in Type 1 Diabetes Mellitus (Type 1 DM)

Irina Demikhova, Susanne Bechtold Dalla Pozza, Claudia Weissenbacher, Carmen Sydlik, Julia Roeb & Heinrich Schmidt


University Childrens Hospital, Munich, Germany


Background: Type 1 DM is an autoimmune disease, characterized by destruction of the insulin-producing beta-cells in the islets of Langerhans. The absolute insulin deficiency leads to metabolic imbalance with hyperglycaemia, acidosis and proneness to ketosis. This acute disturbance can change thyroid hormone metabolism.

Objective and hypotheses: To examine the influence of metabolic acidosis/ketoacidosis in type 1 DM on thyroid hormone levels.

Method: In this retrospective study, we analysed 48 patients (pts) treated at our hospital between 2010 and 2014. Lab data of this 48 pts (30 female, 18 male, mean age 9.4±4.1 years) were examined for influence of pH, BE, anion gap, HbA1c, insulin antibodies and BMI on the fT3 level.

Results: A significant correlation could be identified between BE and fT3 level. Low fT3 was noted in 86% and normal fT3 in 14% of 28 pts with metabolic acidosis. In 12 pts diagnosed for ketoacidosis only 1 patient had normal and 11 pts had low fT3 level. Thyroid hormone levels became normal after the stabilisation of metabolic status (mostly during 3–5 days.

Conclusion: Low fT3 syndrome should not be interpreted as hypothyroidism, but as a protective mechanism during an acute stressful event in type 1 DM. The level of fT3 partly reflects in the metabolic derangements.

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