Almost a quarter (17-30%) of patients with Type 1 diabetes mellitus will have evidence of autoimmune thyroid disease. Autoimmune thyroid disease can result in hypothyroidism or hyperthyroidism.


Screening tests:

(1) anti-thyroglobulin antibodies

(2) anti-thyroid peroxidase antibodies

(3) TSH


Screening tests should be run:

(1) at initial diagnosis

(2) development of thyromegaly

(3) signs of hypo- or hyperthyroidism

(4) impaired linear growth in a pediatric patient

(5) periodically every 1-2 years


If the TSH is abnormal then consider measuring free T4 levels.


Consequences of hypothyroidism:

(1) reduced linear growth in pediatric patients

(2) hypoglycemia


Consequences of hyperthyroidism:

(1) difficult metabolic control


A patient with autoimmune thyroid disease may show antibodies to other endocrine organs as part of a polyendocrinopathy.


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