Background: Metformin is an antidiabetic drug, especially important for type 2 diabetes treatment. Recently it has been reported that metformin is able to interfere with thyroid hormone profile in hypothyroid patients under levothyroxine treatment. However, no data are available for untreated hypothyroid patients or for euthyroid diabetic patients. Objective: To evaluate the correlation between metformin treatment and thyroid function in type 2 diabetic patients. The long-term effects of metformin on thyroid hormones were assessed in diabetic patients with primary hypothyroidism who were either untreated or treated with levothyroxine, as well as in diabetic patients with normal thyroid function. Results: After 2 years of metformin administration, a significant thyrotropin decrease (P < 0.001) was observed in diabetic subjects with hypothyroidism who were either treated (n = 30, from 2.74 ± 1.35 to 1.27 ± 1.17 mIU/l) or untreated (n = 20; 3.01 ± 0.21 vs 4.91 ± 1.12 mIU/L) with levothyroxine, but not in 50 euthyroid subjects. No significant change in free T4 was observed in any group. Conclusions: Metformin administration influenced thyrotropin levels without change of FT4 in patients with type 2 diabetes mellitus and concomitant hypothyroidism. For this reason, the need for reevaluation of thyroid function in these patients 6, 12, and 24 months after starting metformin is indicated.
BackgroundThyroid dysfunction is relatively common in patients with schizophrenia.This study seeks to determine the prevalence and pattern of thyroid dysfunction and thyroid antibodies presence in a group of adult psychiatric inpatients with chronic schizophrenia.MethodsThyroid function tests and thyroid antibodies measurement were performed on 88 patients hospitalized in Psichiatric Clinic of UHC “Mother Teresa” from december 2006 to december 2007.55 of them (62,5%) were females and 33 of them (37,5%) males. A median age of 43 years (range16 to 70 years) and a median duration of hospitalization of 10 years (range 1 to 30 years) was assessed.ResultsTAb were found in 22 patients (25%), of which 18 females and 4 males. 16% of them resulted with positive anticorps for Hashimoto Thyroiditis; 9% for Graves‘disease.According to thyroid function tests70% had normal test, 8% had elevated TSH: 3% of them with low thyroid hormones and 5% with normal thyroid hormones. 20% of cases had low TSH: 5% of them with high level of thyroid hormones, 15% with normal thyroid hormones. Hypothyroidism was more frequent in elderly patients ( > 60 years old), and in those treated with Risperidone. Most of cases (73%) with thyroid disorders resulted from endemic geographic areas. 37% of them mentioned familial history for thyroid pathology, and 23% for diabetes mellitus type 1.ConclusionThyroid abnormalities are common in patients with chronic schizophrenia.This fact call for caution in the use and interpretation of thyroid function tests in these patients.
Background: Depression is frequent in people with diabetes mellitus, particularly in those with microvascular complications, as diabetic nephropathy is. Objective: To realise a two years prospective study in T2DM patients with diabetic nephropathy, in order to explore the impact of depression in them. Methods and materials: A prospective, observational study was realised at a hospital and two diagnostic centers in Tirana. 110 patients (55 males and 55 females) with T2DM, aged ≥ 20 years were enrolled in 2008. Exclusion criteria were personal and familial history for mental illness. For each patient were prescribed: gender, age, duration of diabetes, oldness of diabetic nephropathy, blood glucose level, HbA1c level, UAE level, education and nature of work. The evaluation of depression was done according to Hamilton Depression Scale, by psychiatrists. Results: 83% of the studied cases with diabetic nephropathy resulted with a level of depression. 39% of them result with mild depression, 31% with moderate depression, 21% with severe depression and 9% with very severe depression. Depression was strongly associated with age, male gender, HbA1c levels, UAE rate, duration of diabetic nephropathy, the presence of diabetic retinopathy and diabetic foot disease, education level and mental work. However, the likelihood of depression was not significant with duration of diabetes and insulin use. Conclusions: This study showed high prevalence of depression in type 2 diabetic patients with diabetic nephropathy. So, the management of chronic complications of diabetes is important for the depression prevention in type 2 DM patients.
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