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Hyperthyroidism and Diabetes Mellitus An Analysis of 70 Patients

Hyperthyroidism and Diabetes Mellitus An Analysis of 70 Patients Abstract • Hyperthyroidism developed in 70 patients with diabetes mellitus. Nine patients had masked hyperthyroidism with weight loss as the main sign. Diabetic control deteriorated in 28 of 48 insulin-dependent patients and in four of 22 taking hypoglycemic agents orally. Recurrent ketoacidosis occurred in two. Insulin requirements increased in 11 of 48 by 25% to 100% (mean, 50%). Following treatment of the hyperthyroidism, insulin requirements decreased in 13 of 48 by 20% to 100% (mean, 35%). Four of 22 patients were changed from orally ingested hypoglycemic drugs to insulin. Because of similar symptoms, underlying hyperthyroidism must be considered in any patient whose diabetes is poorly controlled. (Arch Intern Med 140:370-373, 1980) References 1. Kreines F, Jett M, Knowles HC: Observations in hyperthyroidism of abnormal glucose tolerance and other traits related to diabetes mellitus. Diabetes 14:740-743, 1965. 2. Thomas FB, Mazzaferri EL, Skillman TG: Apathetic thyrotoxicosis: A distinctive clinical and laboratory entity. Ann Intern Med 72:679-685, 1970.Crossref 3. Andreani D, Menzinger G, Falluca F, et al: Insulin levels in thyrotoxicosis and primary myxedema: Response to intravenous glucose and glucagon. Diabetologia 6:1-7, 1970.Crossref 4. Aranda A, Montoya E, Herrera E: Effects of hypo- and hyperthyroidism on liver composition, blood glucose, ketone bodies and insulin in the male rat. Biochem J 128:597-604, 1972. 5. Elrick HG, Hlad CT, Arai YJ: The influence of thyroid function on carbohydrate metabolism and a new method for assessing response to insulin. J Clin Endocrinol Metab 21:387-392, 1971.Crossref 6. Hales CN, Hyams DE: Plasma concentrations of glucose, nonesterified fatty acid and insulin during oral glucose tolerance test in thyrotoxicosis. Lancet 2:69-71, 1964.Crossref 7. Marecik RL, Feldman JM: Effect of hyperthyroidism on insulin and glucose dynamics in rabbits. Endocrinology 92:1604-1611, 1973.Crossref 8. Renauld A, Andrade LL, Sverlik RC, et al: Serum insulin response to glucose infusion in hyperthyroid dogs. Horm Metab Res 6:400-403, 1974.Crossref 9. Doar JW, Stamp TC: Effects of oral and intravenous glucose loading in thyrotoxicosis: Studies of plasma glucose, free fatty acids plasma insulin and blood pyruvate levels. Diabetes 18:633-639, 1969. 10. Maxon HR, Kreines KW, Goldsmith RE, et al: Long-term observations of glucose tolerance in thyrotoxic patients. Arch Intern Med 135:1477-1480, 1975.Crossref 11. Kozak GP: Diabetes and other endocrinological disorders , in Marble A, White P, Bradley RF, et al (eds): Joslin's Diabetes Mellitus , ed 11. Philadelphia, Lea & Febiger, 1971, pp 671-675. 12. Abt AR: Hyperthyroidism and diabetes. Metabolism 11:202-212, 1962. 13. Eller M, Silver L, Yohalem SB, et al: The treatment of toxic nodular goiter with radioactive iodine: Ten years' experience with 436 cases. Ann Intern Med 52:976, 1960. 14. Holdworch CD, Besser GM: Influence of gastric emptying rate and of insulin response on oral glucose tolerance in thyroid disease. Lancet 2:700-702, 1968. 15. Volpe R: The role of autoimmunity in hypoendocrine and hyperendocrine function. Ann Intern Med 87:86-99, 1977.Crossref 16. Solomon DH: The nature of Graves' hyperthyroidism, in Brown J (moderator): Autoimmune thyroid diseases: Graves' and Hashimoto's. Ann Intern Med 88:379-391, 1978.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Hyperthyroidism and Diabetes Mellitus An Analysis of 70 Patients

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References (18)

Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1980.00330150084021
Publisher site
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Abstract

Abstract • Hyperthyroidism developed in 70 patients with diabetes mellitus. Nine patients had masked hyperthyroidism with weight loss as the main sign. Diabetic control deteriorated in 28 of 48 insulin-dependent patients and in four of 22 taking hypoglycemic agents orally. Recurrent ketoacidosis occurred in two. Insulin requirements increased in 11 of 48 by 25% to 100% (mean, 50%). Following treatment of the hyperthyroidism, insulin requirements decreased in 13 of 48 by 20% to 100% (mean, 35%). Four of 22 patients were changed from orally ingested hypoglycemic drugs to insulin. Because of similar symptoms, underlying hyperthyroidism must be considered in any patient whose diabetes is poorly controlled. (Arch Intern Med 140:370-373, 1980) References 1. Kreines F, Jett M, Knowles HC: Observations in hyperthyroidism of abnormal glucose tolerance and other traits related to diabetes mellitus. Diabetes 14:740-743, 1965. 2. Thomas FB, Mazzaferri EL, Skillman TG: Apathetic thyrotoxicosis: A distinctive clinical and laboratory entity. Ann Intern Med 72:679-685, 1970.Crossref 3. Andreani D, Menzinger G, Falluca F, et al: Insulin levels in thyrotoxicosis and primary myxedema: Response to intravenous glucose and glucagon. Diabetologia 6:1-7, 1970.Crossref 4. Aranda A, Montoya E, Herrera E: Effects of hypo- and hyperthyroidism on liver composition, blood glucose, ketone bodies and insulin in the male rat. Biochem J 128:597-604, 1972. 5. Elrick HG, Hlad CT, Arai YJ: The influence of thyroid function on carbohydrate metabolism and a new method for assessing response to insulin. J Clin Endocrinol Metab 21:387-392, 1971.Crossref 6. Hales CN, Hyams DE: Plasma concentrations of glucose, nonesterified fatty acid and insulin during oral glucose tolerance test in thyrotoxicosis. Lancet 2:69-71, 1964.Crossref 7. Marecik RL, Feldman JM: Effect of hyperthyroidism on insulin and glucose dynamics in rabbits. Endocrinology 92:1604-1611, 1973.Crossref 8. Renauld A, Andrade LL, Sverlik RC, et al: Serum insulin response to glucose infusion in hyperthyroid dogs. Horm Metab Res 6:400-403, 1974.Crossref 9. Doar JW, Stamp TC: Effects of oral and intravenous glucose loading in thyrotoxicosis: Studies of plasma glucose, free fatty acids plasma insulin and blood pyruvate levels. Diabetes 18:633-639, 1969. 10. Maxon HR, Kreines KW, Goldsmith RE, et al: Long-term observations of glucose tolerance in thyrotoxic patients. Arch Intern Med 135:1477-1480, 1975.Crossref 11. Kozak GP: Diabetes and other endocrinological disorders , in Marble A, White P, Bradley RF, et al (eds): Joslin's Diabetes Mellitus , ed 11. Philadelphia, Lea & Febiger, 1971, pp 671-675. 12. Abt AR: Hyperthyroidism and diabetes. Metabolism 11:202-212, 1962. 13. Eller M, Silver L, Yohalem SB, et al: The treatment of toxic nodular goiter with radioactive iodine: Ten years' experience with 436 cases. Ann Intern Med 52:976, 1960. 14. Holdworch CD, Besser GM: Influence of gastric emptying rate and of insulin response on oral glucose tolerance in thyroid disease. Lancet 2:700-702, 1968. 15. Volpe R: The role of autoimmunity in hypoendocrine and hyperendocrine function. Ann Intern Med 87:86-99, 1977.Crossref 16. Solomon DH: The nature of Graves' hyperthyroidism, in Brown J (moderator): Autoimmune thyroid diseases: Graves' and Hashimoto's. Ann Intern Med 88:379-391, 1978.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Mar 1, 1980

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