Endocrine Abstracts

Introduction: Type 1 Diabetes is an auto-immune disease caused by a disturbance of the immune system, damaging the Beta-cells. The association with other auto-immune diseases was frequently described, and dysthyroidism represents an important part of these associations. In type 1 diabetes, the hormonal profile can be disturbed regardless of auto-immunity. The goal of our study the thyroid hormonal profile in type 1 diabetes, as well as the prevalence of auto-immune dysthyroidism associated with it.

Material and methods: This is a retrospective cross-sectional study based on the observation of patients admitted for diabetes with insulin deficiency. The positivity of anti-pancreas antibodies testified to the auto-immune characteristic; anti glutamic acid decarboxylase GAD and/or anti tyrosine phosphatase IA2. The goal is to determine the type 1 diabetic patients’ thyroid hormonal profile, and the auto-immune dysthyroidism profile.

Results: Our series was conducted with 359 patients: 209 men and 150 women, aged between 10 and 69 years with an average of 28.75 years. The clinical picture was ketotic in the majority of cases: 336 (93.6%), with inaugural ketosis in 313 cases (87.2%). Insulin deficiency varied between one week an 36 months, with an average of 3.75 months and a standard deviation of 6.8 months, exceeding 6 months achieving a slow form and a previous oral treatment in 24% of cases. Regarding weight, the average BMI was 22 (extremes: 15 and 39), over 30 in 22 patients. Upon admission, average blood sugar levels were 16.40 mmol/l with an average glycosylated hemoglobin HbA1C of 12.32%. Average TSH levels were of 3.23 mUI/l and the average T4 levels=12.43 pg/l in 242 patients who had thyroid function tests. Auto-immune thyropathies were frequent: 54 patients (71% of cases). Hashimoto’s disease dominated the etiologic profile and was confirmed by the presence of anti-TPO antibodies found in 37 patients (48.6% of cases). Basedow’s disease was found in 17 other patients (22.3% of cases) with positive anti-TSH receptor antibodies.

Conclusion: Type 1 Diabetes is common in adults and children, and the association with auto-immune diseases is frequent, hence the necessity of looking for these diseases when patients are diagnosed with diabetes.