The finding indicates that insufficient thyroid hormone supplementation can worsen glucose metabolism, and therefore should be avoided.
This surgery is most common for thyroid cancer.
The People with thyroid cancer New research shows that treatment with thyroidectomy increases by 40% the risk of developing type 2 diabetes, regardless of age, with higher risks observed with low and high doses of levothyroxine after surgery.
“This is the first population-based study to show an elevated risk of type 2 diabetes in patients Post thyroidectomy with thyroid cancercompared to matched controls,” the authors wrote in a paper recently published in Clinical Endocrinology & Metabolism.
“In particular, there was a U-shaped relationship between the postoperative dose of levothyroxine, a surrogate marker of TSH suppression, and the risk of type 2 diabetes,” says Hye Jin Yoo, MD, division of endocrinology and metabolism. from Korea University College of Medicine, Seoul, colleagues.
Tyler Drake, MD, an endocrinologist with System Minneapolis VA Health Care, said that while other studies have linked thyroidectomy for thyroid cancer to a higher risk of other metabolic conditions, including coronary heart disease and stroke, the relatively higher risk of disease Unexpected diabetes. Department.
“The 40% increase in diabetes risk is a big surprise,” said Dr. Tyler Drake.
“Diabetes is very common, with 1 in 10 American adults having type 2 diabetes, but the risk of thyroid cancer is 40% higher than what I see in my clinical practice. [Sin embargo]Drake, who is also an assistant professor of medicine at the University of Minnesota, Minneapolis, said:
Abnormal thyroid function, including hypothyroidism and hyperthyroidism, after thyroidectomy and subsequent levothyroxine treatment, are known to have potentially adverse effects on glucose regulation in thyroid cancer patients.
Possible mechanisms linking hypothyroidism to diabetes specifically include the possibility of insulin being unable to enhance glucose utilization by muscle and adipose tissue. However, the authors noted that thyroid hormone replacement was associated with normalization of insulin sensitivity.
Meanwhile, glucose intolerance is common among hyperthyroid patients, largely due to increased glucose production in the liver, and similarly, normal thyroid levels among those treated with methimazole have been linked to normalization of glucose and changes in lipid metabolism. .
Drake noted that a major limitation of the study was that patients were analyzed based on levothyroxine dose and not TSH values, which the authors explained was caused by unavailability of TSH values.
“Given the levothyroxine doses, not the TSH values, it is possible that some patients have received inadequate treatment with too much or too little levothyroxine,” Drake noted.
However, the findings highlight the risk of developing diabetes after thyroidectomy for thyroid cancer, Anupam Kotwal, MD, commented on the study.
“This study is important because it addresses an important topic that explores the link between hypothyroidism and metabolic disease, in this case hypothyroidism, due to thyroid cancer surgery and type 2 diabetes,” said Cotwal, associate medical professor in the department. MD in diabetes, endocrinology, and metabolism at the University of Nebraska Medical Center in Omaha.
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