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Hypothyroidism and growth failure in diabetes mellitus
Insights
Thyroid disease is common in children with diabetes. While subclinical hypothyroidism can occur, it rarely causes growth failure in these patients.
Area of Science:
- Endocrinology
- Pediatrics
- Autoimmunity
Background:
- Diabetes mellitus beginning in childhood affects many young individuals.
- Thyroid disease is a known comorbidity in patients with diabetes.
- Familial autoimmunity may play a role in the clustering of these conditions.
Purpose of the Study:
- To describe the prevalence of thyroid disease in children, adolescents, and young adults with childhood-onset diabetes mellitus.
- To investigate the association between family history of thyroid disease, thyrogastric antibodies, and autoimmune thyroid conditions.
- To assess the impact of hypothyroidism, including subclinical hypothyroidism, on growth in this patient population.
Main Methods:
- Study population: 134 children, adolescents, and young adults with diabetes mellitus.
- Assessment of thyroid disease prevalence and diagnosis of hypothyroidism.
- Evaluation of family history of thyroid disease and presence of thyrogastric antibodies.
- Monitoring of growth patterns in patients with and without hypothyroidism.
Main Results:
- Thyroid disease was prevalent in the studied cohort of diabetic patients.
- Familial clustering and autoimmune markers (thyrogastric antibodies) were observed.
- Hypothyroidism was diagnosed in 7 patients (4 overt, 3 subclinical).
- Only one case of overt hypothyroidism was associated with significant growth faltering.
Conclusions:
- Subclinical hypothyroidism should be considered in diabetic patients with faltering growth.
- However, subclinical hypothyroidism is infrequently the primary cause of growth failure in this population.
- The findings support the role of familial autoimmunity in the development of thyroid disease among diabetic youth.
Abstract:
The prevalence of thyroid disease in 134 children, adolescents, and young adults with diabetes mellitus beginning in childhood is described. Clustering of a family history of thyroid disease and the presence of thyrogastric antibodies in some patients supports the concept of familial autoimmunity. In 4 children a diagnosis of hypothyroidism had already been made, one of whom had shown marked faltering of growth. In a further 3 there was evidence of previously unrecognised subclinical hypothyroidism but the growth of 2 of them had been good. The findings of this study indicate that while subclinical hypothyroidism should be considered in a diabetic whose growth is faltering, it is rarely a cause of such growth failure.