THYROID GLAND RESPONSES TO THERAPEUTIC INTERVENTIONS IN ELDERLY DIABETES TYPE 1 AND TYPE 2 SUBJECTS OF NORTHERN PAKISTAN

Abstract

A total of 330 study participants with type 1 and type 2 diabetes were involved in the study in a noninterventional setting, they were placed on different therapies for diabetes and thyroid disorders based on clinical protocols. The objective of these treatments was to evaluate their impact on thyroid gland function. Thyroid stimulating hormone (TSH), total thyroxine (T4), free thyroxine (fT4), total triiodothyronine (T3), and free triiodothyronine (fT3) levels were measured to evaluate the thyroid gland's functional status across different therapeutic interventions. It was observed that TSH levels were significantly elevated in subjects treated with insulin alone for type 1 diabetes, as well as in those receiving a combination of insulin and oral antidiabetic drugs for type 2 diabetes. Furthermore, T4 and fT4 levels were significantly reduced in groups with elevated TSH levels, indicating a decrease in thyroxine biosynthesis and subsequent negative feedback response on TSH secretion. Similar patterns were observed in the levels of free T3 (fT3), suggesting a reduction in triiodothyronine biosynthesis. Notably, T3 levels were also lowered in subjects receiving oral antidiabetic drugs alone or in combination with other treatments. The findings highlight the importance of periodic monitoring of thyroid function in type 2 diabetic subjects undergoing oral antidiabetic treatment, as these medications may adversely affect thyroid function and necessitate adjustments in treatment strategies. Overall, the study underscores the need for careful consideration and management of thyroid function in diabetic patients undergoing various therapeutic interventions, to optimize treatment outcomes and minimize potential adverse effects.