Evaluation of Thyroid Dysfunction among Type 2 Diabetic Patients in a Tertiary Care Hospital

Background: Diabetes mellitus is the commonest endocrine disease and many diabetic patients suffer from thyroid dysfunction (TD) later in their life.Thyroid hormones directly control insulin secretion and insulin clearance.Diabetes also may affect the thyroid function to variable extent first at the level of hypothalamic control of TSH release and second at the peripheral tissue by converting T4 to T3. Aims and objectives:The present study was carried out to determine the prevalence of thyroid dysfunction (TD) among type 2 Diabetes mellitus (T2DM) patients in a tertiary care hospital. Methodology: A cross-sectional hospital-based study was conducted to find out the prevalence of TD among 246 admitted T2DM patients in the medicine ward of Sylhet MAG Osmani Medical College Hospital of Bangladesh in 2022. They were investigated for fasting blood glucose (FBG), glycosylated haemoglobin (HbA1c), two hours post-prandial glucose (2HPPG), free tri-iodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH).Results: Prevalence of TD in T2DM was found in 25.6% patients.Gender-specific prevalence found higher in males (28.9%) compared to females (21.6%) (P=0.194).Age-specific prevalence found higher in the age group (41-50 yrs) (30.8%) compared to other age groups (P=0.493).Subjects with poor glycaemic control (HbA1c 7.1-10%) demonstrated higher prevalence (32.5%) (P=0.135).Subjects with long-standing T2DM (10-12 years) had an increased risk for thyroid dysfunction (41.4%) (P=0.122).There is significant correlation between P=0.001) which will need further research. Conclusion:The prevalence of TD was quite high (25.6%)among T2DM.We found more males (28.9%) with TD compared to females (21.6%) and especially hypo-thyroidism (19.9%) being more typical than hyperthyroidism (5.7%).Also, a continuous negative correlation of FT4 with FBG and 2HPPG were found.Hence, universal screening and regular monitoring of TD in T2DM patients are recommended.