Effects of thyroid hormone replacement on glycated hemoglobin levels in non diabetic subjects with overt hypothyroidism

Anantarapu, Sailaja; Suresh, V.; Sachan, Alok; Phaneendra, Bobbidi Venkata; Suchitra, MM; Reddy, Amaresh P; Epuri, Sunil; Mukka, Arun; Vemvakam, Dharaneswari

doi:10.1590/2359-3997000000065

Cited by 16 publications

(12 citation statements)

References 22 publications

(25 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may have limited the power to detect slight changes in insulin sensitivity and glycemia, whereas the changes in body composition were readily detected. However, similar results were observed by other authors as well [23,24,25]. …”

Section: Discussionsupporting

confidence: 92%

“…These findings are similar to those observed by Handisurya et al [23], Kim et al [24], and Anantarapu et al [25], who showed that there were no changes observed in plasma glucose following the correction of hypothyroidism. No difference was observed between fasting glucose and insulin between hypothyroid patients with autoimmune thyroid disease (n = 12) and euthyroid participants (n = 12) in the study by Zybek-Kocik et al [26].…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Correction of Hypothyroidism Leads to Change in Lean Body Mass without Altering Insulin Resistance

et al. 2016

Self Cite

View full text Add to dashboard Cite

Background: Hypothyroidism is associated with insulin resistance, dyslipidemia, and abnormal body composition. This study assessed changes in body composition and insulin resistance after thyroxine (T₄) replacement in overt hypothyroidism. Methods: In this prospective longitudinal study carried out in a tertiary care center, adult nondiabetic patients with overt hypothyroidism were rendered euthyroid on T₄. Anthropometry including skinfold thickness (SFT) at the triceps and subscapularis was recorded. Patients underwent testing for fasting plasma glucose, creatinine, serum insulin, T₄, thyrotropin (TSH) and body composition analysis by dual-energy X-ray absorptiometry (DEXA) both before and at 2 months after restoration to the euthyroid state. Results: Twenty-seven patients (20 female and 7 male) aged 35.3 ± 11.0 years (min-max: 17-59 years) with overt hypothyroidism were recruited. Serum T₄ at the time of recruitment was 48.9 ± 24.6 nmol/l (normal range = 64.4-142 nmol/l). All patients had TSH ≥50 µIU/l. Following treatment, there was a mean body weight reduction of 1.7 kg (p = 0.01). Waist circumference as well as triceps and subscapularis SFT decreased significantly (p < 0.001). There was no change in fat mass (FM), percentage of fat (%FM) or bone mineral content in any of the specified regions or in the body as a whole. In contrast, mean lean body mass (LBM) decreased significantly by 0.8 kg (p < 0.01) in the trunk and 1.3 kg (p < 0.01) in the whole body. Insulin resistance and level of glycemia were not affected by treatment with T₄. Conclusion: LBM decreases significantly without affecting FM after correction of hypothyroidism. Insulin resistance was not influenced by T₄ treatment.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Correction of Hypothyroidism Leads to Change in Lean Body Mass without Altering Insulin Resistance

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…The reasons for low sensitivity of HbA1c in patients with thyroid dysfunction remain unclear. One reason may be the alteration of erythrocytes in circulation caused by thyroid dysfunction (10,15). OGTT may not account for nocturnal hyperglycemia, which was observed in the present report.…”

Section: Discussioncontrasting

confidence: 54%

“…However, previous studies identified that HbA1c is not a reliable diagnostic test for diabetes in the presence of hyperthyroidism or hypothyroidism (9,10).…”

Section: Introductionmentioning

confidence: 99%

Glucose metabolism before and after radioiodine therapy of a patient with Graves' disease: Assessment by continuous glucose monitoring

Yan

et al. 2017

Biomedical Reports

View full text Add to dashboard Cite

Abstract. Hyperthyroidism causes impaired glucose tolerance, insulin resistance (IR) and insulin secretion. However, the glucose variability affected by thyroid dysfunction remains unclear. Glucose variability was assessed by continuous glucose monitoring (CGM) in a non-diabetic patient with Graves' disease (GD), to the best of our knowledge, for the first time. A 28-year-old man with GD, who had been taking methimazole for 4 years, was treated with radioiodine on August 17th 2016. Although the patient exhibited normal glycated hemoglobin (HbA1c; 5.3%) and blood glucose values during the oral glucose tolerance test (OGTT; fasting and 120 min blood glucose were 5.38 and 6.39 mmol/l, respectively) before radioiodine therapy, CGM exhibited high 24 h mean glucose and nocturnal hyperglycemia. An increased fasting insulin level, suppressed levels of blood glucagon and high homeostatic model assessment of IR were also observed. The disordered glucose metabolism improved as soon as the patient's thyroid function turned to hypothyroidism 4 months after radioiodine therapy. The glucose intolerance in patients with hyperthyroidism, missed by the OGTT and HbA1c tests, may be more common than anticipated.

show abstract

“…11 The correlation which was seen in this study was also shown by another study which significantly correlated TSH and HbA1c (r =0.46, p <0.05). 12 Anantarapu et al 13 showed the comparison between the HbA1c, FBG and PBG at baseline and at 3 months after the correction of hypothyroidism. While there was a fall in the HbA1c from 5.8 ± 0.7% to 5.6 ± 0.5% (p = 0.009) following the treatment of hypothyroidism, there were no corresponding changes in the FBG and PBG.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of diabetes mellitus on the basis of HbA1c: Is this true in hypothyroidism also?

Singhai

Kabra

2016

Asian J Med Sci

View full text Add to dashboard Cite

Background: Hypothyroidism may leads to hypoproliferative anemia. It is possible that this reduced erythropoiesis may result false elevation of HbA1c in some cases and further leading to an erroneous diagnosis of pre diabetes or diabetes.Aims and Objective: This study was planned to assess changes in HbA1c after initiation of thyroxine replacement in patients with subclinical and overt hypothyroidism.Settings and Design: This prospective study was conducted at Department of General Medicine of a tertiary care centre over one year.Methods and Material: 100 subjects were recruited for the study. Fasting blood glucose, serum creatinine, hemoglobin, HbA1c, reticulocyte count, serum free T4 and TSH estimation done in all subjects. Hypothyroid patients were started on thyroxine. After three months of documentation of euthyroidism, same investigations were repeated.Statistical analysis used: Statistical software, SPSS version 17.0 was used for analysis.Results: After correction of hypothyroidism, TSH decreased from 92.3(±30.9) to 3.4±2.9 µIU/L and 12.2(±4.5) to 4.4±2.9 µIU/ml in overt hypothyroidism and subclinical hypothyroidism respectively. There was a statistically significant fall in the HbA1c (SD) from 5.9% (0.8) to 5.6% (0.6) and 6.0% (0.3) to 5.7% (0.3) following the correction of hypothyroidism in overt hypothyroidism and subclinical hypothyroidism respectively. However, there were no statistically significant changes in the fasting as well as postprandial blood glucose.Conclusions: Our study demonstrated that HbA1c values are falsely increased in patients with hypothyroidism. This falsely raised HbA1c became normal after thyroxine supplement.Asian Journal of Medical Sciences Vol.7(6) 2016 36-39

show abstract

Effects of thyroid hormone replacement on glycated hemoglobin levels in non diabetic subjects with overt hypothyroidism

Cited by 16 publications

References 22 publications

Correction of Hypothyroidism Leads to Change in Lean Body Mass without Altering Insulin Resistance

Correction of Hypothyroidism Leads to Change in Lean Body Mass without Altering Insulin Resistance

Glucose metabolism before and after radioiodine therapy of a patient with Graves' disease: Assessment by continuous glucose monitoring

Diagnosis of diabetes mellitus on the basis of HbA1c: Is this true in hypothyroidism also?

Contact Info

Product

Resources

About