Prevalence Of Thyroid Dysfunction Among Type 2 Diabetes Mellitus Patients In Urban Areas Of Belagavi

Abstract

Introduction: Diabetes is a major disease burden in India and we are home to the second largest number of diabetes cases in the world with currently over 72 million cases of diabetes. Type 2 diabetes mellitus and thyroid disorders are highly prevalent disorders in the community. Both have been shown to mutually influence each other. Recognition of this interdependent relationship between thyroid disease and diabetes is of significance in guiding clinicians towards optimal management of both these conditions. The existing data regarding prevalence of thyroid disorders in patients with diabetes comes mostly from facility based studies. Objective: To determine the prevalence of thyroid dysfunction among type 2 diabetes mellitus patients and the risk factors associated with it Methodology: Data was collected from type 2 diabetes mellitus patients residing in areas under the Urban Health Centre Ashok Nagar and Rukmini Nagar which are under the field practice area of Department of Community Medicine, Jawaharlal Nehru Medical College, Belagavi.Periodic camps were conducted in the study areas to identify the known case of type 2 diabetes mellitus patients. From the identified T2DM patients, study participants were selected based on the selection criteria. After obtaining informed written consent pre designed and pre tested questionnaire was used to collect information about socio-demographic profile, risk behaviors, general physical examination, systemic and thyroid examination. Venous blood samples were collected to estimate thyroid profile (T3, T4, TSH), FBS and PPBS. Statistical analysis was done using chi square test for categorical variables. Univariate and multivariate logistic regression analysis were used for association between various parameters with thyroid dysfunction and ‘P’ value less than 0.05 was considered significant. Results: Of the 380 study participant, 29.73% were in the age group of 61 - 70 years and 25.52% were in the age group of 51 – 60 years forming the majority of the participants. The average age of the study participant was 56.25 ± 11.24 (mean ± S.D.) with a range of 32 to 80 years of age. 60.26% were females forming the major portion and 39.74% were males. Majority of the study participants were home makers (55.79%) and self-employed were 20.26%. 30% of the participants did not have any kind of formal education; 23.42% of them studied up to secondary and 22.63% primary school; Majority of study participants belonged to SES class IV (32.37%); 65.53% of participants were Hindus; most of them were married (88.15%) and 52.37% of the participants were living in a joint family. The prevalence of thyroid disorders was 21.58%. Sub-clinical hypothyroidism was more common than other conditions which constituted 13.68% of the thyroid dysfunction in the type 2 diabetes mellitus patients. Clinical hypothyroidism was 1.85%; hyperthyroidism was 6.05% [clinical hyperthyroidism (3.94%) and subclinical hyperthyroidism (2.11%)]. Statistically significant association was observed with factors such as gender, physical activity during leisure time, waist hip ratio and glycemic status with p value less than 0.05. Multivariate analysis demonstrated the presence of thyroid disorder was related with glycemic status of the participants with odds ratio 1.85 (CI, 0.996 – 3.443). Conclusion: This study shows that a significant proportion of type 2 diabetes patients suffer from thyroid dysfunction and screening for the same should be routinely considered, as it is found to be an additional co-morbidity