Endocrine Abstracts

Introduction: Among the most common chronic non-communicable diseases in India, Type-2 Diabetes mellitus (T2DM) and hypertension (HT) are increasingly becoming a matter of public health importance. Hypothyroidism is also believed to be a common health issue in India, with one out of 10 people in the country diagnosed with the condition. Hence the objective of this cross-sectional, clinico-epidemiological, Pan-India study was to evaluate the prevalence of hypothyroidism in patients with T2DM or HT or both T2DM and HT and to understand the management practices in Indian real-world setting.

Methods: Adults (≥18 years) with a diagnosis of T2DM or HT or both (established or newly diagnosed), visiting physician for routine check-up, were enrolled in this study. Overt hypothyroidism was defined as TSH >4.50 μIU/ml (FT4: <0.8 ng/dl; FT3: <1.4 pg/ml); subclinical hypothyroidism (SCH) as TSH >4.50 μIU/ml (FT4: 0.8–1.8 ng/dl; FT3: 1.4–4.4 pg/ml). Descriptive statistics was used for statistical analysis.

Results: A total of 1501 (99.5%) patients completed the study (T2DM:500 [99.2%]; HT:499 [99.6%]; both T2DM and HT: 502 [99.8%]). Mean (±S.D.) age of the population was 52.9±12.49 years. In patients with known case of hypothyroidism, 86 (17.1%), 111 (22.2%), and 87 (17.3%) patients had history of T2DM, HT and both T2DM and HT, respectively. In patients with T2DM, the newly diagnosed cases of hypothyroidism were 38 (7.6%; SCH: 5.2%) versus 86 (17.2%) previously diagnosed cases. In patients with HT, newly diagnosed cases of hypothyroidism were 58 (11.6%; SCH: 8.2%) versus 109 (21.8%) old cases. Among patients with T2DM and HT, the newly diagnosed cases of hypothyroidism were 58 (11.6%; SCH: 6.4%) versus 87 (17.3%) previously diagnosed cases. Overall prevalence of hypothyroidism in T2DM (n=1002) and HT (n=1001) was 26.85% and 31.17% respectively. In T2DM patients with newly diagnosed SCH, 16 (61.5%) patients were prescribed with thyroxine. In HT patients with newly diagnosed SCH, 25 (61.0%) patients were prescribed with thyroxine. In patients with T2DM and HT, newly diagnosed with SCH, 20 (62.5%) patients were prescribed with thyroxine. Most commonly prescribed dose of thyroxine was 25 μg for SCH in all cohorts.

Conclusion: We conclude that screening for thyroid disease among patients with T2DM and HT should be routinely performed considering the prevalence of newly diagnosed cases in the study. This study thus emphasizes on the extent of overlap between these diseases and highlights the need for early diagnosis for effective management/better outcome.