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Journal of Endocrinological Investigation

, Volume 41, Issue 4, pp 389–393 | Cite as

TSH oscillations in young patients with type 1 diabetes may be due to glycemic variability

  • G. Bellastella
  • M. I. Maiorino
  • L. Scappaticcio
  • O. Casciano
  • M. Petrizzo
  • M. Caputo
  • V. A. Paglionico
  • D. Giugliano
  • K. Esposito
Original Article

Abstract

Purpose

A relationship between thyroid dysfunction and diabetes mellitus has been described by several authors but the role of glycemic variability is still unclear. We planned the present study to evaluate the influence of glycemic variability on thyroid hormones and TSH concentrations in patients with type 1 diabetes mellitus (T1DM).

Methods

Seventy-seven young patients with T1DM were enrolled and evaluated for basal glucose concentrations, HbA1c, thyroid hormones and TSH concentrations. Glucose variability was investigated by considering the standard deviation of blood glucose readings and by calculating the mean amplitude of glycemic excursions and continuous overlapping net glycemic action (CONGA). The low (LBGI) and high (HBGI) blood glucose indices were also calculated. The correlations between TSH, thyroid hormones, glycemia and HbA1c were studied in patients and in controls, whereas those between TSH, thyroid hormones and indices of glucose variability only in patients.

Results

No correlations were observed in T1DM patients between free thyroid hormones and glycemic values, HbA1c and indices of glucose variability, while an inverse correlation was observed between TSH levels and glycemic values (r = −0.27; p = 0.01), CONGA index (r = −0.35; p = 0.001) and HBGI (r = −0.28; p = 0.01) but not with HbA1c (r = −0.1; p = 0.47).

Conclusions

Our results suggest a direct action of glycemic excursions on TSH secretion, regardless of variations of thyroid hormone concentrations. Thus, the evaluation of thyroid function through the assay of TSH concentrations in these patients should be made, if possible, by multiple samples on patients in euglycemic state to avoid underestimation or overestimation of thyroid dysfunction due to a wrong diagnosis of euthyroidism or dysthyroidism with consequent inappropriate choice of therapeutic options.

Keywords

TSH Type 1 diabetes Glycemic variability CONGA MAGE LBGI 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Italian Society of Endocrinology (SIE) 2017

Authors and Affiliations

  • G. Bellastella
    • 1
  • M. I. Maiorino
    • 1
  • L. Scappaticcio
    • 1
  • O. Casciano
    • 1
  • M. Petrizzo
    • 1
  • M. Caputo
    • 1
  • V. A. Paglionico
    • 1
  • D. Giugliano
    • 1
  • K. Esposito
    • 2
  1. 1.Endocrinology and Metabolic Diseases Unit, Department of Medical, Surgical, Neurological, Metabolic, Geriatric Sciences and AgingUniversity of Campania “L. Vanvitelli”NaplesItaly
  2. 2.Diabetes Unit, Department of Medical, Surgical, Neurological, Metabolic Sciences and AgingUniversity of Campania “L. Vanvitelli”NaplesItaly

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