It has long been recognised that thyroid hormones have marked effects on glucose homeostasis. Glucose intolerance is associated with hyperthyroidism and most recently it was shown that hypothyroidism is characterised by insulin resistance. Although autoimmune thyroid disease is more prevalent in type 1 diabetes as a result of their common origin, in patients with type 2 diabetes the prevalence of hypothyroidism and hyperthyroidism is similar to that of the general population. However, in type 2 diabetic patients, the presence of the highly frequent sub-clinical forms of hyperthyroidism and hypothyroidism should be ruled out since they may be associated with higher cardiovascular risk. While there are no doubts about the therapeutic impact of normalising hypothyroidism and hyperthyroidism, the information available about the benefit of treating subclinical thyroid disease in diabetes remains insufficient.
Lenzen S., Bailey CJThyroid hormones, gonadal and adrenocortical steroids and the function of the islets of Langerhans. Endocr Rev1984;5:411-34.
3.
Boelaert K., Franklyn JAThyroid hormone in health and disease. J Endocrinol2005;187:1-15.
4.
Hollowell JG , Staehling NW, Flanders WD et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab2002;87:489-99.
5.
Canaris GJ, Manowitz NR, Mayor G. et al. The Colorado thyroid disease prevalence study. Arch Intern Med2000;160:526-34.
6.
Surks MI, Hollowell JGAge-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism . J Clin Endocrinol Metab2007;92:4575-82.
7.
Wiersinga WMSubclinical hypothyroidism and hyperthyroidism. I. Prevalence and clinical relevance. Neth J Med1995;46:197-204.
8.
Pearce SH, Merriman TRGenetics of type 1 diabetes and autoimmune thyroid disease. Endocrinol Metab Clin N Am2009;38:289-301.
9.
Perros P., McCrimmon RJ, Shaw G. et al. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet Med1995;12:622-7.
10.
Kordonouri O., Maguire AM, Knip M. et al. Other complications and associated conditions with diabetes in children and adolescents. Pediatric Diabetes2009;10:204-10.
11.
Abalovich M. , Amino N., Barbour LA et al. Management of thyroid dysfunction during pregnancy and postpartum: An Endocrine Society clinical practice guideline . J Clin Endocrinol Metab2007;92:S1-47.
12.
Chubb SA, Davis WA, Inman Z.Prevalence and progression of subclinical hypothyroidism in women with type 2 diabetes: the Fremantle Diabetes Study. Clin Endocrinol (Oxf) 2005;62:480-6.
13.
Gambelunghe G., Forini F., Laureti S. et al. Increased risk for endocrine autoimmunity in Italian type 2 diabetic patients with GAD65 autoantibodies. Clin Endocrinol2000;52:565-73.
14.
Libman IM, Sun K., Foley TP, Becker DJThyroid autoimmunity in children with features of both type 1 and type 2 diabetes . Pediatr Diabetes2008;9:266-71.
15.
Uzunlulu M. , Yorulmaz E., Oğuz A.Prevalance of subclinical hypothyroidism in patients with metabolic syndrome. Endocr J2007;54: 71-6.
16.
Standards of medical care in diabetes: 2008. Diabetes Care2008; 31(suppl 1):S12.
17.
Kordonouri O., Maguire AM, Knip M et al. International Society for Pediatric and Adolescent Diabetes. ISPAD Clinical Practice Consensus Guidelines 2006-2007. Other complications and associated conditions. Pediatr Diabetes2007;8:171-6.
18.
Raboudi N., Arem R., Jones RH et al. Fasting and postabsorptive hepatic glucose and insulin metabolism in hyperthyroidism. Am J Physiol1989;256:E159-66.
19.
Weinstein SP , O’Boyle E., Fisher M., Haber RSRegulation of GLUT2 glucose transporter expression in liver by thyroid hormone: evidence for hormonal regulation of the hepatic glucose transport system. Endocrinology1994 :135:649-54.
20.
Viguerie N. , Millet L., Avizou S. et al. Regulation of human adipocyte gene expression by thyroid hormone. J Clin Endocrinol Metab2002; 87:630-4.
21.
Clément K., Viguerie N., Diehn M. et al. In vivo regulation of human skeletal muscle gene expression by thyroid hormone. Genome Res2002;12:281-91.
22.
Moeller LC, Dumitrescu AM, Walker RL et al. Thyroid hormone responsive genes in cultured human fibroblasts . J Clin Endocrinol Metab2005;90:936-43.
23.
Potenza M., Via MA, Yanagisawa RT et al. Excess thyroid hormone and carbohydrate metabolism. Endocr Pract2009;15:254-62.
24.
Dimitriadis G., Baker B., Marsh H. et al. Effect of thyroid hormone excess on action, secretion, and metabolism of insulin in humans. Am J Physiol1985;248:E593-601.
25.
Muller MJ, Acheson KJ, Jequier E., Burger AGEffect of thyroid hormones on oxidative and nonoxidative glucose metabolism in humans. Am J Physiol1988;255:E146-52.
26.
Shen DC, Davidson MB, Kuo SW, Sheu WHPeripheral and hepatic insulin antagonism in hyperthyroidism. J Clin Endocrinol Metab1988; 66:565-9.
27.
Dimitriadis G., Mitrou P., Lambadiari V. et al. Insulin-stimulated rates of glucose uptake in muscle in hyperthyroidism: the importance of blood flow. J Clin Endocrinol Metab2008;93:2413-15.
28.
Ortega E., Koska J., Pannacciulli N. et al. Free triiodothyronine plasma concentrations are positively associated with insulin secretion in euthyroid individuals. Eur J Endocrinol2008;158:217-21.
29.
Ximenes HM, Lortz S., Jörns A., Lenzen S.Triiodothyronine (T3)-mediated toxicity and induction of apoptosis in insulin-producing INS-1 cells. Life Sci2007;80:2045-50.
30.
Rochon C., Tauveron I., Dejax C. et al. Response of glucose disposal to hyperinsulinemia in human hypothyroidism and hyperthyroidism. Clin Sci2003;104:7-15.
31.
Handisurya A., Pacini G., Tura A. et al. Effects of thyroxine replacement therapy on glucose metabolism in subjects with subclinical and overt hypothyroidism . Clin Endocrinol (Oxf) 2008;69:963-9.
32.
Dimitriadis G. , Mitrou P., Lambadiari V. et al. Insulin action in adipose tissue and muscle in hypothyroidism. J Clin Endocrinol Metab2006;91:4930-7.
33.
Brenta G., Celi FS, Pisarev M. et al. Acute thyroid hormone withdrawal in athyreotic patients results in a state of insulin resistance. Thyroid2009;19:665-9.
34.
Andreani D., Menzinger G., Fallucca F. et al. Insulin levels in thyrotoxicosis and primary myxoedema: response tointravenous glucose and glucagon. Diabetologia1970;6:1-7.
35.
Maratou E., Hadjidakis DJ, Kollias A. et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. Eur J Endocrinol2009;160:785-90.
36.
Müller MJ , Paschen U., Seitz HJThyroid hormone regulation of glucose homeostasis in the miniature pig. Endocrinology1983;112:2025-31.
37.
Okajima F., Ui M.Metabolism of glucose in hyper and hypothyroid rats in vivo. Glucose turnover values and futile cycle activities obtained with 14 C and 3H labelled glucose . Biochem J1979;182:565-75.
38.
McCulloch AJ, Nosadini R., Pernet A. et al. Glucose turnover and indices of recycling in thyrotoxicosis and primary thyroid failure. Clin Sci1983;64:41-7.
39.
Bakker SJ, ter Maaten JC, Popp-Snijders C.The relationship between thyrotropin and low density lipoprotein cholesterol is modified by insulin sensitivity in healthy euthyroid subjects. J Clin Endocrinol Metab2001;86:1206-11.
40.
Chubb SA, Davis WA, Davis TMInteractions among thyroid function, insulin sensitivity, and serum lipid concentrations: The Fremantle Diabetes Study. J Clin Endocrinol Metab2005;90:5317-20.
41.
Chidakel A. , Mentuccia D., Celi FSPeripheral metabolism of thyroid hormone and glucose homeostasis. Thyroid2005;15:899-903.
42.
Surks MI, Ortiz E., Daniels GH et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA2004;291:228-238.
43.
Brown J., Solomon DHMechanism of antithyroid effects of a sulfonyl-urea in the rat. Endocrinology1958;63:473.
44.
Cappelli C. , Rotondi M., Pirola I. et al. TSH-lowering effect of metformin in type2 diabetic patients. Differences between euthyroid, untreated hypothyroid and euthyroid on L-T4 therapy patients. Diabetes Care2009;32:1589-90.
45.
Starkey K., Heufelder A., Baker G. et al. Peroxisome proliferator-activated receptor-gamma in thyroid eye disease: contraindication for thiazolidinedione use?J Clin Endocrinol Metab2003;88:55-9.
Brenta G., Danzi S., Klein I.Potential therapeutic applications of thyroid hormone analogs. Nat Clin Pract Endocrinol Metab2007; 3:632-64.
48.
Baxter J., Webb P.Thyroid hormone mimetics: potential applications in atherosclerosis, obesity and type 2 diabetes. Nat Rev Drug Discov2009 ;8:308-20.
49.
Biondi B., Cooper DSThe clinical significance of subclinical thyroid dysfunction. Endocr Rev2008;29:76-131.
50.
Chen HS, Wu TE, Jap TS et al. Subclinical hypothyroidism is a risk factor for nephropathy and cardiovascular diseases in type 2 diabetic patients. Diabet Med2007;24:1336-44.
51.
Yang JK, Liu W., Shi J., Li YBAn association between subclinical hypothyroidism and sight-threatening diabetic retinopathy In type 2 diabetic patients. Diabetes Care2010;33:1018-20.
52.
Haentjens P. , Van Meerhaeghe A., Poppe K. et al. Subclinical thyroid dysfunction and mortality: an estimate of relative and absolute excess all-cause mortality based on time-to-event data from cohort studies. Eur J Endocrinol2008;159:329-41.
53.
Sathyapalan T., Manuchehri AM, Rigby AS, Atkin SLSubclinical hypothyroidism is associated with reduced all-cause mortality in patients with type 2 diabetes. Diabetes Care2010;33:e37.
54.
Ochs N., Auer R., Bauer DC et al. Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality. Ann Intern Med2008;148:832-45.
55.
Razvi S., Shakoor A., Vanderpump M. et al. The influence of age on the relationship between subclinical hypothyroidism and ischemic heart disease: a metaanalysis. J Clin Endocrinol Metab2008;93: 2998-3007.
