Clinical and metabolic features of the course of type 1 diabetes in children with autoimmune thyroid diseases

Objective. To evaluate the relationship of autoimmune thyroid diseases in children with type 1 diabetes with glycemic control and lipid profile, ketoacidosis at diabetes diagnosis, characteristics of the partial remission.

Materials and methods. A comparative analysis of glycated hemoglobin and lipid profile was performed in 52 children with autoimmune polyglandular syndrome type 3a, 95 patients with type 1 diabetes and 30 healthy children. We conducted a retrospective analysis of the data derived from the patients' medical records: diabetic ketoacidosis, thyroid status at diabetes diagnosis; glycated hemoglobin levels, daily insulin doses and insulin dose-adjusted glycated hemoglobin in the year after diabetes onset.

Results. Children with polyglandular autoimmunity and decompensated hypothyroidism had a higher frequency of dyslipidemia with triglyceride concentrations above optimal values (> 1.1 mmol/L) compared to patients with autoimmune polyglandular syndrome type 3a and normal thyroid status (p = 0.018), type 1 diabetes (p = 0.008), and the control (p = 0.029); and low-density lipoprotein cholesterol (> 2.6 mmol/L) – compared to the control (p = 0.024). Children with combined endocrinopathies and decompensated thyroid status at the disease onset had a higher frequency of diabetic ketoacidosis than patients with type 1 diabetes (p = 0.036). In children with polyglandular autoimmunity and thyroid dysfunction at diabetes onset were found higher daily insulin doses (p = 0.001) and insulin dose-adjusted glycated hemoglobin (p = 0.038) in 12 months after the disease diagnosis compared to the peers with only type 1 diabetes.

Conclusions. The obtained results demonstrate an association between thyroid dysfunction in children with type 1 diabetes and an increased risk of diabetic ketoacidosis at the disease onset, more rapid progression of type 1 diabetes and dyslipidemia.

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