[Thyroid response to exogenous TSH stimulation in diabetic patients]. / Respuesta del tiroides al estímulo con TSH exógena en pacientes diabéticos.

Complicated diabetic patients have a marked decrease of plasmatic level of T3 and a less important decrease of T4. They are caused by the alteration of the extra-thyroid T3 formation from T4 and lower TSH release. 11 patients with a different metabolic state had a basal determination of T3 and T4 and 6 hours after the administration of 5 Units of TSH intramuscular in order to see whether those changes described previously existed in any other intrinsic thyroid alteration secondary to complicated diabetes. The median increases observed were between normal limits (T3: 96%; T4: 45%) and in accordance with this, a direct correlation between glycemia and its respective rate of hormonal increase were observed as well, without any statistical significance (r = 0.56 in T4; r = 0.36 in T3). These results allow us to confirm that there is not an eventual thyroid function alteration during complicated diabetes as opposed to the afore-mentioned increase of the extra-thyroid factors.

[Decompensated diabetes mellitus and circadian rhythm of plasma TSH]. / Diabetes mellitus descompensada y ritmo circadiano de la TSH plasmática.

The plasmatic levels of TSH in 2 group of diabetic patients (7 decompensated and 8 decompensated, but in treatment) were measured at 9:30 and 23:30 hours. The mean glycemia levels were of 280 +/- 45 and 150 +/- 30 mg/dl (p less than 0.0005). There was no significant difference between daily TSH and nocturnal TSH in any of the groups, but there was a tendency for the nocturnal TSH to be higher in decompensated patients. There was no difference when comparing the TSH of the first group to the TSH of the 2nd group. The mean TSH N/TSH D was superior by 1 (1.36 in decompensated and 1,095 in treated patients). The correlation between glycemia and TSH D was negligible in all groups. The data suggests the tendency that the circadian rhythm of TSH in maintained in diabetes decompensation with shorter rhythm registered in treated patients. This shows a certain normality in the suprahypophysary area in charge of the rhythm and is similar to the minor liberation of TSH after TRH stimulus that other authors have described as happening in the decompensation of diabetes mellitus.