EVALUATION OF THYROID DYSFUNCTION IN TYPE 2DIABETIC PATIENTS IN SOKOTO METROPOLIS

CHAPTER ONE

 

1.0             INTRODUCTION

Diabetes mellitus (DM) and thyroid dysfunction (TD) are the two most common endocrine disorders seen in adult population(Diezet al., 2011).The prevalence of Type2 diabetes mellitus (T2DM) is rising faster than any other form of diabetes because of increased urbanization which encourages development of obesity due to reduced physical activities,increase consumption of refined foods and snacks globally (Zimmet, 1999; Zimmetet al., 2001).Thyroid hormones, namely Triiodothyronine (T3) and Thyroxine (T4); either or both of which may be elevated or reduced have both direct and indirect effect on blood glucose homeostasis (Udionget al.,2007). 

Elevated levels of free circulating thyroid hormones (hyperthyroidism) produce hyperglycemia by causing polyphagia,enhancing glucose absorption from gastro-intestinal tract, accelerating insulin degradation and stimulating glycogenolysis (Webb,2004).Reduced level of the hormones hypothyroidism may cause hypoglycemia (Webb,2004; Cooper, 2003).

Hypothyroidism, the most commonly diagnosed thyroid dysfunction has greater implications for Type2 diabetic in whom there is pre-existing dyslipidemia and risk of cardiovascular disease (Cooper,2003;Rama et al; 2003; Johnson, 2006).Moreover, thyroid hormones have significant effects on the synthesis, mobilization and metabolism of lipid (Dias et al., 2011; Murray et al., 2000). Overt hypothyroidism is associated with significant increase in circulating concentration of total and low density lipoproteins cholesterol (LDL-C) (Elder et al.,1990; Staubet al.,1992; O’Brien et al.,1993).

Several cross-sectional studies have examined the association between thyroid dysfunction and metabolic abnormalities, however, few studies have looked at this in Type 2diabetes mellitus (Tasminet al., 2011).Two of such studies on thyroid dysfunction in Type 2 diabetes mellitus (T2DM) were reported in Portugal and Jordan (Perroset al, 1995;Radaideh and Ajlouni, 2004).The study by Ghazali and Abbeyesuku, (2010) on prevalence of thyroid dysfunction on Type 2 diabetes mellitus (T2DM) was in Ibadan, Nigeria.Cordosoet al., (1995) reported on Type 1 diabetic Nigerians in Lagos while Udionget al, (2007) studied a mixed population of diabetic Nigerians in Calabar.Therefore, there is need to evaluate, the pattern of thyroid dysfunction in Type 2 diabetic population in Sokoto metropolis.

1.1             Justification

Therelationship between Thyroid dysfunction (TD) and Type 2 diabetes mellitus (T2DM) is characterized by a complex interaction of inter-dependence of physiologic and biochemistry of insulin and its influence on the metabolism of carbohydrates,proteins and lipid.Screening of thyroid dysfunction especially at subclinical dysfunction,in patients with diabetes mellitus (DM) is justifiable because most patients can be asymptomatic.  

1.2             Aim

The aim of the work is to evaluate thyroid dysfunction in Type 2 diabetic patients attending Endocrinology Clinic (Diabetic Clinic) of UsmanuDanfodiyo

University Teaching Hospital,Sokoto, Sokoto State.    

1.3Specific Objectives

1.            Tomeasure blood glucose level in Type 2 diabetic patients and (control) non diabetic patients.

2.            To measure glycatedhemoglobin (HbA1c) level in Type 2 diabetic

patients and non diabetic patients. 

3.            To measure thyroid hormones namely TSH, T3 and T4  inType 2 diabetic patients and non diabetic patients.

4.            To measure lipid profile in Type 2 diabetic patients and non diabetic

patients. 

5.            To correlate between indices of Thyroid Dysfunction and Type 2 diabetics mellitus (T2DM).     

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