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Associated conditions and other complications
Thyroid disease
Thyrotoxicosis
- Diagnosed less frequently than hypothyroidism in association with diabetes
- May be transient and occasionally precedes hypothyroidism (or vice versa)
Diagnostic pointers
- Agitation
- Tachycardia
- Weight loss
- Heat intolerance
- Tremor
- Possibly increasingly unstable metabolic control
Definitive diagnosis
Raised total (or free) thyroxine, raised triiodothyronine, with TSH suppressed below normal range (raised TSH receptor-stimulating antibodies)
Treatment
Anti-thyroid drugs such as carbimazole, methimazole, propylthiouracil
Recommendations
- Regular clinical examination of the thyroid gland in all young
people with diabetes for detection of goiter
- Close to the time of diagnosis of diabetes, thyroid function and
thyroid antibody tests should be performed as a baseline or to
uncover asymptomatic thyroid disease
- Repeat thyroid function tests should be performed if a child with
diabetes develops a goiter, has slow growth velocity, has
symptoms suggestive of thyroid disease or has high titers of
thyroid antibodies
- Many centers repeat the thyroid function tests as part of an
annual review
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