Thyroid Dysfunction Among Diabetic Patients at the Diabetic Endocrine Hospital, Tripoli, Libya, 2022
DOI:
https://doi.org/10.64229/v77qpz13Keywords:
Thyroid dysfunction, Diabetes mellitus, PrevalenceAbstract
Background: Thyroid dysfunction is a common endocrine disorder that frequently coexists with diabetes mellitus (DM) and may negatively affect metabolic control and long-term outcomes. Objective: This study aimed to determine the prevalence and pattern of thyroid dysfunction among diabetic patients and to evaluate its association with sociodemographic and clinical variables. Methods: A cross-sectional study was conducted among 256 diabetic patients attending the Diabetic Endocrine Hospital in Tripoli, Libya, in 2022. Demographic data, clinical characteristics, glycemic status, and thyroid function tests were analyzed. Associations of thyroid dysfunction with gender, age, diabetes type and duration, treatment modality, comorbidities, and family history were assessed. Results: Of the 256 diabetic patients included in the study, 95 (37.1%) had thyroid dysfunction, while 161 (62.9%) were euthyroid. Hypothyroidism was the most prevalent thyroid disorder (35.2%). Thyroid disease developed after the diagnosis of diabetes in 25.8% of affected patients. Thyroid dysfunction was significantly more common among females compared with males (p < 0.001) and among patients with type 1 diabetes compared with type 2 diabetes (p < 0.001). A longer duration of diabetes (≥11 years) was also significantly associated with thyroid dysfunction (p = 0.038). Patients receiving insulin therapy had a higher prevalence of thyroid dysfunction (p = 0.005). A positive family history of thyroid disease was strongly associated with thyroid dysfunction (p < 0.001). Previous thyroid surgery and radioactive iodine therapy were also significantly associated with thyroid dysfunction. In multivariate logistic regression analysis, female sex, type 1 diabetes, longer diabetes duration, and a positive family history of thyroid disease remained independently associated with thyroid dysfunction (Table 6). Poor glycemic control (HbA1c ≥ 7%) did not remain independently associated with thyroid dysfunction after adjustment. Conclusion: Thyroid dysfunction is highly prevalent among diabetic patients in Tripoli, particularly among females, those with type 1 diabetes, those with long disease duration, and those with a positive family history. These findings support the need for routine thyroid screening as part of comprehensive diabetes care.
References
[1]Peissig K, Condie BG, Manley NR. Embryology of the parathyroid glands. Endocrinology and Metabolism Clinics of North America, 2018, 47(4), 733-742. DOI: 10.1016/j.ecl.2018.07.002
[2]Hage M, Zantout MS, Azar ST. Thyroid disorders and diabetes mellitus. Journal of Thyroid Research, 2011, 2011, 439463. DOI: 10.4061/2011/439463
[3]Kahaly GJ. Concomitant autoimmune diseases in patients with autoimmune thyroid diseases: A review. European Journal of Endocrinology, 2014, 170(6), R45-R62. DOI: 10.1530/EJE-13-0898
[4]Rapa A, Monzani A, Vitti P. Prevalence of thyroid disease in Italian children and adolescents with type 1 diabetes mellitus. Italian Journal of Pediatrics, 2019, 45, 151. DOI: 10.1186/s13052-019-0738-5
[5]Kut A, Kalli H, Anil C, Mousa U, Gursoy A. Knowledge, attitudes and behaviors of physicians towards thyroid disorders and iodine requirements in pregnancy. Journal of Endocrinological Investigation, 2015, 38(10), 1057-1064. DOI: 10.1007/s40618-015-0312-0
[6]De Ruyter S, Van de Weijer T, Hermus A. Coexistence of thyroid dysfunction and diabetes mellitus. Acta Clinica Belgica, 2017, 72(2), 100-106. DOI: 10.1080/17843286.2016.1257434
[7]Lu MC, Chang SC, Huang KY, Koo M, Lai NS. Higher risk of thyroid disorders in young patients with type 1 diabetes: A 12-year nationwide, population-based, retrospective cohort study. PLoS One, 2016, 11(3), e0152168. DOI: 10.1371/journal.pone.0152168
[8]Khan R, Awadai A, Alghorry N, Albalawi H, Alwadai I, Alatawi M, et al. Prevalence of thyroid disease among type 2 diabetic patients in Tabuk city, Saudi Arabia. Indo American Journal of Pharmaceutical Sciences, 2019, 6(1), 2520-2524. DOI:10.13140/RG.2.2.27867.00808
[9]Hammadi SH, Aljawi RS, Alahdal SS, Allahyani MM, Jazzar NK, Maqbol SM, et al. Prevalence of thyroid dysfunction among type 2 diabetic patients in Makkah and Jeddah, Saudi Arabia. The Egyptian Journal of Hospital Medicine, 2018, 70(8), 1312-1316. DOI: 10.12816/0044640
[10]Elmenshawi IM, Alotaibi SS, Alazmi AS, Alazmi AM, Alruwaili FR, Alazmi NN, et al. Prevalence of thyroid dysfunction in diabetic patients. Journal of Diabetes, Metabolic Disorders & Control, 2017, 4(2), 55-60. DOI: 10.15406/jdmdc.2017.04.00106
[11]Abdlmola TO, Azbida AG, Atiya A, Mosbah E, Fathi H, Nasser R, et al. Prevalence of thyroid disorders in diabetic patients in Tarhuna area, Libya. Derna Academy Journal for Applied Sciences, 2023, 1(2), 52-58. DOI: 10.71147/ek3bvh39
[12]Elkituni A, Elshwekh H, Bendala NM, Atwear WS, Aldaba FA, Fellah AM. Profile of diabetic ketoacidosis at the national diabetes and endocrine center in tripoli, Libya. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2021, 15(3), 771-775. DOI: 10.1016/j.dsx.2021.03.014
[13]Palma CCSSV, Pavesi M, Nogueira VG, Clemente ELS, Vasconcellos MFBMP, Júnior LCP, et al. Prevalence of thyroid dysfunction in patients with diabetes mellitus. Diabetology & Metabolic Syndrome, 2013, 5(1), 58. DOI: 10.1186/1758-5996-5-58
[14]Sakyi SA, Ameyaw B, Laing EF, Anthony R, Ephraim RKD, Effah A, et al. Thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus patients in Ghana: A comparative cross - sectional study. Endocrinology, Diabetes & Metabolism, 2023, 6(6), e447. DOI: 10.1002/edm2.447
[15]Bukhari SI, Ali G, Memon MY, Sandeelo N, Alvi H, Talib A, et al. Prevalence and predictors of thyroid dysfunction among patients with type 2 diabetes mellitus in Pakistan. Journal of Family Medicine and Primary Care, 2022, 11(6), 2739-2743. DOI: 10.4103/jfmpc.jfmpc_2106_21
[16]Liu Y, Li X, Zhu YK, Liu J, Liu SJ. Subclinical hypothyroidism contributes to poor glycemic control in patients with type 2 diabetes mellitus, and ellagic acid attenuates methimazole-induced abnormal glucose metabolism in mice model. Journal of Food Biochemistry, 2021, 45(6), e13753. DOI: 10.1111/jfbc.13753
[17]Kumar R, Patel N, Singh A. Thyroid disorders in diabetic patients: Prevalence and clinical impact. Frontiers in Endocrinology, 2022, 13, 935210. DOI: 10.3389/fendo.2022.935210
[18]Ogbonna SU, Ezeani IU. Risk factors of thyroid dysfunction in patients with type 2 diabetes mellitus. Frontiers in Endocrinology, 2019, 10, 440. DOI: 10.3389/fendo.2019.00440
[19]Berta E, Lengyel I, Halmi S, Zrínyi M, Erdei A, Harangi M, et al. Hypertension in thyroid disorders. Frontiers in Endocrinology, 2019, 10, 482. DOI: 10.3389/fendo.2019.00482
[20]Popoviciu MS, Paduraru L, Nutas RM, Ujoc AM, Yahya G, Metwally K, et al. Diabetes mellitus secondary to endocrine diseases: An update of diagnostic and treatment particularities. International Journal of Molecular Sciences, 2023, 24(16), 12676. DOI: 10.3390/ijms241612676
[21]Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet, 2017, 390(10101), 1550-1562. DOI: 10.1016/S0140-6736(17)30703-1
[22]Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM, et al. Global epidemiology of hyperthyroidism and hypothyroidism. Nature Reviews Endocrinology, 2018, 14(5), 301-316. DOI: 10.1038/nrendo.2018.18
[23]Díez JJ, Iglesias P. Thyroid dysfunction and diabetes mellitus: Two closely associated disorders. Endocrinologia Diabetes Y Nutricion, 2021, 68(7), 529-539. DOI: 10.1016/j.endinu.2020.12.007
[24]Boulton A. It's time to tackle the growing diabetes pandemic. Diabetes Research and Clinical Practice, 2021, 182, 109158. DOI: 10.1016/j.diabres.2021.109158
[25]Wang CX. The relationship between type 2 diabetes mellitus and related thyroid diseases. Journal of Diabetes Research, 2013, 2013, 390534. DOI: 10.1155/2013/390534
[26]Duntas LH, Orgiazzi J, Brabant G. The interface between thyroid and diabetes mellitus. Clinical Endocrinology, 2011, 75(1), 1-9. DOI: 10.1111/j.1365-2265.2011. 04029.x
[27]Ciężki S, Kurpiewska E, Bossowski A, Głowinska-Olszewska B. Multi-faceted influence of obesity on type 1 diabetes in children - from disease pathogenesis to complications. Frontiers in Endocrinology, 2022, 13, 890833. DOI: 10.3389/fendo.2022.890833
[28]Chen LY, Wang CW, Chen LA, Fang SH, Wang SC, He CS. Low vitamin D status relates to the poor response of peripheral pulse wave velocity following acute maximal exercise in healthy young men. Nutrients, 2022, 14(15), 3074. DOI: 10.3390/nu14153074
[29]World Health Organization. Diabetes, 2024. Available at: https://www.who.int/news-room/fact-sheets/detail/diabetes (accessed on 14 November 2024).
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Halla Elshwekh, Aida Elkituni, Sabria Alturki, Hassan Essamei (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
