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Serum TSH, T 4, T 3, FT 4, FT 3, rT 3, and TBG in Youngsters with Non-Ketotic Insulin-Dependent Diabetes mellitus
Abstract
Several parameters of thyroid function were studied in 112 non-ketoacidotic youngsters with insulin-dependent diabetes mellitus (IDDM). Levels of thyroxine (T<sub>4</sub>), reverse triiodothyronine (rT<sub>3</sub>), thyroxine-binding globulin (TBG) and T<sub>3</sub> were lower than in controls, whereas FT<sub>4</sub>, and FT<sub>3</sub> were normal. T<sub>4</sub> levels in IDDM patients were positively related to T<sub>3</sub>, rT<sub>3</sub> and TBG, and inversely related to haemoglobin Ai (HbA<sub>1</sub>. However, only 4 patients showed biochemical hypothyroidism (T<sub>4</sub> < 5 µg/100 ml), whereas their FT<sub>4</sub>, FT<sub>3 </sub>and thyroid-stimulating hormone (TSH) levels were normal. Concurrent variations of T3 and rT<sub>3</sub> levels were found in IDDM patients; thus, their T<sub>3</sub>/rT<sub>3</sub> ratios were stable or higher than in controls, indicating that peripheral deiodination of T<sub>4</sub> is preferentially oriented to production of rT<sub>3</sub> only during ketoacidosis. Although changes in thyroid function may reflect the degree of metabolic control of diabetes in a large population, the clinical usefulness of serum thyroid hormone measurements in an individual case still appears to be limited.