Saini J S, Naqvi S, Dutt O P
Senior Adviser (Med & Endocrinology), Army Hospital, Delhi Cantt.
Scientist D, Army Hospital, Delhi Cantt.
Med J Armed Forces India. 1995 Apr;51(2):117-121. doi: 10.1016/S0377-1237(17)30941-3. Epub 2017 Jun 26.
Twenty patients of non-insulin-dependent diabetes mellitus (NIDDM) (15 males and 5 females) who developed secondary failure to oral hypoglycaemic drugs, were evaluated for thyroid hormone abnormalities before and after control of diabetic state with insulin. Blood glucose (mean ± SEM mg/dL) fasting and post prandial levels were 260±16 and 370±20 respectively before therapy. After 15 days of intensive insulin therapy these levels fell to 110±14 and 130±12 respectively (p < 0.005). Glycosylated haemoglobin percent (GHb%) (mean ± SEM) was 10±0.4 before therapy and after therapy it fell to 9.2±0.3 (p < 0.05). Serum tri-iodothyronine levels (mean ± SEM ng/mL) were 0.55±0.03 which was significantly lower (p < 0.05) as compared controls. After therapy it significantly (p < 0.05) rose to 1.22±0.08). Serum thyroxine (T4) (mean ± SEM mcg/dL) was 8.5±0.6 before therapy and it did not change significantly after therapy. Serum reverse tri-iodothyronine (rT3) values of (mean ± SEM ng/dl) 0.24±0.05 were higher before therapy and decreased to 0.20±0.82 after therapy. However thyrotropin (TSH) values before and after therapy remained same. There was no significant change in TSH response to thyrotropin releasing hormone (TRH) before and after control of diabetic state. It was concluded that peripheral changes in T3, T4 and rT3 (low T3, high rT3 and low or normal T4) occurred in uncontrolled diabetic state. However, pituitary thyrotroph function in NIDDM with ideal body weight was not significantly affected.
20例非胰岛素依赖型糖尿病（NIDDM）患者（15例男性和5例女性），出现口服降糖药继发性失效，在使用胰岛素控制糖尿病状态前后，对其甲状腺激素异常情况进行了评估。治疗前空腹血糖（均值±标准误mg/dL）和餐后血糖水平分别为260±16和370±20。强化胰岛素治疗15天后，这些水平分别降至110±14和130±12（p<0.005）。糖化血红蛋白百分比（GHb%）（均值±标准误）治疗前为10±0.4，治疗后降至9.2±0.3（p<0.05）。血清三碘甲状腺原氨酸水平（均值±标准误ng/mL）为0.55±0.03，与对照组相比显著降低（p<0.05）。治疗后显著升高（p<0.05）至1.22±0.08）。血清甲状腺素（T4）（均值±标准误mcg/dL）治疗前为8.5±0.6，治疗后无显著变化。治疗前血清反三碘甲状腺原氨酸（rT3）值（均值±标准误ng/dl）为0.24±0.05，治疗后降至0.20±0.82。然而，治疗前后促甲状腺激素（TSH）值保持不变。糖尿病状态控制前后，TSH对促甲状腺激素释放激素（TRH）的反应无显著变化。结论是，在未控制的糖尿病状态下，T3、T4和rT3出现外周变化（低T³、高rT³和低或正常T4）。然而，理想体重的NIDDM患者垂体促甲状腺细胞功能未受到显著影响。
