Background: Type 1 diabetes mellitus (T1DM) is the most common endocrine disease in children and adolescents.
Objective and hypotheses: It was aimed to evaluate the frequency of autoimmune thyroiditis (AT) and the possible risk factors for AT at diagnosis and at follow up of T1DM patients.
Method: T1DM patients who were admitted to Trakya University Medical Faculty Pediatric Department, Pediatric Endocrinology Outpatient Clinic between January 2006 and September 2013 were evaluated.
Results: The mean age of 134 (63 M, 71 F) cases was 11.3±4.6 years, mean diagnosis age of diabetes was 8.1±3.9 years and mean diabetes duration was 3.1±2.4 years. Most of the cases were diagnosed at spring and winter, and most common administration reason was diabetic ketoacidosis (52.7%). At the diagnosis of T1DM, mean HbA1c was %12.3±2.7 and mean C-peptide was 0.43±0.39 ng/ml. Glutamic acid decarboxylase, anti-insulin and islet cell antibodies were positive in 47.4%, 1.7% and 0.9% of the cases, respectively. AT was found in 19 (5 M, 14 F) out of 134 cases (%14.2). The mean age of these cases was 13.9±3,6 years and diabetes duration was 4.2±2.9 years. At the diagnosis of AT 68,4% of cases were between ages 10 and 15 years and 78.9% were pubertal. All cases were euthyroid at diagnosis but six of them then developed subclinical hypothyroidism. Sex, age, puberty, anthropometric measures, clinical and laboratory findings at the time of diagnosis of T1DM were similar in AT positive and negative cases. The mean age was higher and number of pubertal cases was more in T1DM cases with AT.
Conclusion: In conclusion, AT incidence is high in T1DM cases, especially at puberty. At the time of diagnosis, cases with AT are mostly euthyroid but because thyroid dysfunction may be seen in the feature, close follow up is crucial. Therefore, T1DM cases should be assessed for thyroid autoantibodies and thyroid hormones annually.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology