Thyroid diseases - ally or enemy of type 1 diabetes in children and adolescents?

Introduction
Autoimmune thyroid diseases (AIT) are one of the most common disorders associated with type 1 diabetes (T1D) and they are capable of influencing its course. For Hashimoto’s lymphocytic thyroiditis, the incidence is 14–28%, while for Graves-Basedow hyperthyroidism it is 0.5–7%. Aim of the study: Assessment of type 1 diabetes in the pediatric population with coexisting autoimmune thyroid diseases: Hashimoto’s lymphocytic thyroiditis and Graves-Basedow’s disease.

Material and methods
Analyzing publications from the PubMed scientific database from 1990 to May 2020.

Results
Among pediatric patients with T1D and coexisting thyroid autoimmunity insufficient glycemic control is usually observed. Reported average increase in glycated hemoglobin concentration ranges from 7.9 to 9.2%. In children with T1D and subclinical hypothyroidism, an increased number of episodes of hypoglycemia was noted – 5 vs. 2 episodes per year among children with euthyroidism. In hyperthyroidism patients the number of episodes of hypoglycemia was 34.4 vs. 17.2 per 100 incidents in euthyroidism patients. An increased occurrence of diabetic ketoacidosis events may also be observed – 18.1 vs. 7.7 per 100 patients with euthyroidism per year. The risk of developing chronic complications in the form of cardiovascular diseases is also higher. However, basing on the available literature, this subject is still debatable.

Conclusions
Autoimmune thyroid diseases often accompany and interfere with type 1 diabetes in children and adolescents. Paying special attention to the different course of diabetes in the presence of thyroid disorders is an important and essential element of diabetes care.