Friday, January 27, 2023

Bidirectional relationship between diabetes and thyroid conditions such as hypothyroidism

A 2019 study revealed that Puerto Rico has the third highest number of thyroid cancer cases in the world. Now, it has become possible to establish the link between diabetes and thyroid so that measures can be taken in case of high incidence.

Dr. Leticia Hernandez, who was with us at the Diabetes Prevention Forum. Photo: Journal of Medicine and Public Health.

Within the framework of the Puerto Rico Forum: the coalition under the control of diabetesDoctor. leticia hernandezendocrinologist and president of the Puerto Rican Society endocrine Diabetology Talks Journal of Medicine and Public Health about the relationship between diabetes And this Thyroid,

Various studies have shown that diabetes type 1 and Thyroid They are strongly linked, as they are autoimmune conditions. which results in hypothyroidism I hyperthyroidism: “When we are diagnosed with an autoimmune condition, we may have antibodies for many autoimmune conditions,” Dr. Hernandez says.

In March this year, Dr. Hernandez revealed that, according to a study, Puerto Rico is the country with the third highest number of breast cancer cases. Thyroid in the world. Based on the data, 40 per 100,000 in Puerto Rican women versus 19.4 per 100,000 in the United States.

However, this reflects a high incidence, which refers to the authorities creating prevention and training programs for the population, as well as raising awareness of the condition.

thyroid and diabetes

The thyroid gland is an organ found at the base of the neck and produces hormones that help control heart rate, blood pressure, body temperature, the reproductive system, fat metabolism, and other metabolic aspects.

Faced with this scenario, Dr. Hernandez assures that there is a connection between Thyroid And this diabetes Type 1, as both are autoimmune conditions. “We know that living with patients diabetes type 1, both are more likely to develop hypothyroidism As hyperthyroidism“, says the endocrinologist.

Now, facing relation with diabetes Type 2, Hernandez assures, can exist “both in terms of growth and control,” he says. he says that patients who have diabetes type 2, develop hypothyroidism,

Diabetes: Hypothyroidism and Hyperthyroidism

It is important to clarify what differentiates one from the other. For starters, complications of this gland occurs when Thyroid (gland) not producing enough hormones (hypothyroidism), or when it produces them in excess (hyperthyroidism, In the course of the struggle that science has given, it has been possible to establish that diabetes It is characterized by a decrease in the production of insulin and in the face of these changes ThyroidThe danger increases.

“In terms of control, we know that hyperthyroidism It’s going to speed up your metabolism and part of that is insulin metabolism. This may mean that we have to optimize the insulin treatment of the patient who has hyperthyroidism“, he assures.

On the other hand, in the case of ” hypothyroidismthat insulin clearance is delayed, and in this case we have a higher risk of hypoglycemia,” Hernandez says.

hypothyroidism, bidirectional relationship

“This relationship is bidirectional, and it has been hypothesized that people diabetes type 2, there is an increased risk of developing hypothyroidism Because, it is understood that there is a dysregulation of what is the pituitary’s response to stimulation by the hypothalamus. The hypothalamus releases TRH which is thought to stimulate the pituitary to release TSH, and this dysregulation forces us to increase that level of TSH, in order to have an adequate response that can eventually lead to hypothyroidism too,” he clarifies.

these diabetics who develop hypothyroidism Weight gain goes along with insulin resistance: “Several meta-analysis studies have found that patients at risk of diabetesWhen they have high TSH levels, from the high normal ranges to a clear elevation of TSH, the risk can increase to 17% over patients with normal TSH levels,” he explains.

Besides, Dr. Hernandez points out that in patients diabetes that grow hypothyroidism: “The thyroid gland releases mostly T4 hormone, 80% of this production is done by the gland. ThyroidAnd it’s in the white tissues that this hormone is converted to the active hormone, which is the T3 hormone, through some deiodinases, which may have a reduced function that reduces the conversion of T4 to T3, which affects growth. Can do hypothyroidism“, he clarifies.

“No. That means I have to have a clinical evaluation that includes a history of symptoms, what can tell us I have a thyroid condition, and a physical exam,” Hernandez says.

early warning

These are conditions that are linked, you should know about both complications from ThyroidIn form of diabetes reciprocally: “if we have diabetesbe aware of the development of hypothyroidismabout the symptoms that can clue us in that our patients are developing it; be aware of the development of diabetes“, he assures.

“Something very important is that when TSH levels rise, we have to consider physiological reasons for said elevation. Depending on age, TSH levels will rise and continue to rise; weight gain leads to an increase in TSH. This leads us to evaluate whether we are treating a hypothyroidism subclinical, where we have T4 and T3 hormone levels that are normal, or if we have a hypothyroidism Frank,” he says.


Patients who have these conditions experience changes in: “temperature regulation (intolerance to cold or heat), moderate weight gain, fluid accumulation (edema), especially in the face, bowel movements, less frequent bowel movements or constipation, which may indicate that we have a case of hypothyroidism“, reveals.

in the matter of hyperthyroidism The changes that the patient presents are associated with “intestinal transit, more frequent evacuations”, he assures.

“I have a history, a physical exam that goes along with a differential diagnosis of a condition likely Thyroid When determining whether I am going to perform an evaluation test in these patients. These are conditions that have to be studied further”, concluded Dr. Hernandez.

View the full forum here.

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