Assessment of thyroid status in children with type 1 diabetes mellitus in Ismailia

ABSTRACT

Diabetes mellitus is defined as a syndrome of disturbed energy homeostasis caused by deficiency of insulin or its action and resulting in abnormal metabolism of carbohydrate, protein and fat. It is the most common endocrine disorder in childhood and adolescence with important consequence on emotional development. Type I diabetes is frequently associated with autoimmune diseases, such as hyperthyroidism, Hashimoto thyroiditis, pernicious anemia, Addison disease, vitiligo, hypoparathyroidism, and myasthenia gravis, thyroid autoimmunity is a remarkably frequent concomitant of type 1 diabetes in childhood. Genetic susceptibility to autoantibody formation in association with autoimmune thyroid diseases [AITD] and type 1 diabetes mellitus has been described with varying frequencies. So the present study is designed to assess thyroid autoimmunity and dysfunction in children with type 1 diabetes mellitus and recognition of possible risk factors. This study is a descriptive study carried out on 64 children with type 1 diabetes mellitus aged 2-18 yr. complete history, physical examination and laboratory testing were done for diabetic children as follows age and sex, history of diabetes mellitus duration, complications, and therapy, history suggestive of autoimmune disease vitiligo, Addison's disease, pernicious anemia, celiac disease and others, family historypaternal consanguinity, history of diabetes mellitus and other endocrinopathy, history of autoimmune diseases, history of thyroid dysfunction and symptoms of hypothyroidism or symptoms of hyperthyroidism. Assessment of thyroid autoantibodies by indirect fluorescent antibody technique [IFA], free T4 and TSH assay were done. Thyroid autoimmunity was detected in 10.9% of diabetic patients [7 patients]. In seven diabetic children, thyroid antibodies levels were elevated on one occasion, whereas 57 patients were antibodies-negative during observation period. In conclusion, these data support and extend the previous findings documenting the high prevalence of thyroid autoimmunity in children and adolescent screened for autoimmune with type 1 diabetes. Also these data support the recommendation for regular testing of thyroid auto antibodies and thyroid hormones