Publication:

Thyroid dysfunction in children with type 1 diabetes mellitus: prevalence, patterns and clinical associations

Background To determine the prevalence and pattern of thyroid dysfunction in children with Type 1 diabetes mellitus, identify associated risk factors that predispose diabetic children to develop thyroid abnormalities and evaluate the impact on glycemic control.

Methods This prospective observational study included 50 children with Type 1 diabetes mellitus attending a tertiary care centre. Clinical characteristics, including age, gender, duration of diabetes, other autoimmune diseases, family history of autoimmunity, along with metabolic parameters like HbA1c and daily insulin requirement, were recorded. Thyroid status was categorised as euthyroid antibody negative, euthyroid antibody positive, subclinical hypothyroidism, overt hypothyroidism and hyperthyroidism. Associations between thyroid status and clinical variables, glycemic parameters were analysed.

Results Thyroid dysfunction was present in 9 children (18%): subclinical hypothyroidism in 4 (8%), overt hypothyroidism in 4 (8%) and hyperthyroidism in 1 (2%). Among the remaining children, 28 (56%) were euthyroid with negative anti–thyroid peroxidase antibodies, while 13 (26%) were euthyroid with positive antibodies. Thyroid dysfunction was significantly associated with longer duration of diabetes and the coexistence of other autoimmune disorders. Daily insulin requirement differed significantly across thyroid subgroups, whereas glycated haemoglobin levels were comparable between T1DM children with and without thyroid dysfunction.

Conclusions Thyroid dysfunction is common in children with Type 1 diabetes mellitus, affecting nearly one-fifth of patients, with subclinical hypothyroidism being a frequent abnormality. Longer duration and presence of other autoimmune diseases increase the risk of thyroid dysfunction. Periodic routine thyroid screening in children with Type 1 diabetes mellitus is essential for early detection and optimal metabolic management.