key: cord-0318212-27ga0r7b
authors: Yimer, R. M.; Tekalign, A. M.; Habte, F. B.
title: Determinants of Thyroid Dysfunction among Type 2 Diabetes Patients Attending Private Hospitals in Dire Dawa, Eastern Ethiopia
date: 2022-02-05
journal: nan
DOI: 10.1101/2022.02.03.22270379
sha: 768dd6a1fb820c9192ca552f9690ac8bfed62832
doc_id: 318212
cord_uid: 27ga0r7b

Purpose The purpose of this study is to capture the determinants of thyroid dysfunction in type 2 diabetes mellitus at private hospitals in Dire-Dawa, Eastern Ethiopia. Various studies found that thyroid dysfunction is common in type 2 diabetes and it is associated with poor blood glucose control and chronic diabetic complications responsible for morbidity and mortality. However, only limited studies have assessed determinants of thyroid dysfunctions among type 2 diabetes in Ethiopia. Methods Unmatched case-control study conducted in two private hospitals found in Dire Dawa town, between May - November 2021. A total of 92 type 2 diabetic patients with thyroid dysfunction as Cases and 183 type 2 diabetes patients with normal thyroid function as controls selected by purposive and systematic random sampling, respectively. Data collected by interview and using checklist, entered into SPSS version 22, and analyzed. Bivariate and multivariate logistic regression analysis employed to identify determinants of thyroid dysfunction with AOR and 95%CI. Independent t-test computed to observe significant mean difference of continuous variables. Variables with P-value < 0.05 declared as significant. Result Female gender predominate 65.9% of participants (p= 0.02). The mean glycated hemoglobin level among cases was 10.32 ({+/-} 2.4 SD) and 9.249 ({+/-} 2.3 SD) among controls, with significant difference (p=0.001). Similarly, the mean LDL cholesterol among cases 116.92 {+/-}45.9 SD and control 102.34 {+/-}43.97SD showed significant difference (p=0.016). Diabetic retinopathy and neuropathy, and ACEI/ARB also significantly associated with thyroid dysfunction (p< 0.05). Conclusion Female gender, lower educational level, and duration of diabetes associated with thyroid dysfunction. Most patients in both groups had unacceptably elevated HgA1c which need to be addressed. Thus, screening for thyroid dysfunction, especially the female gender, needs to be done.

is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 5, 2022. ; https://doi.org/10.1101/2022.02.03.22270379 doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. The magnitude of TD is inconsistent in different parts of the world and relay on the level of 59 iodine sufficiency, race, and population dynamics. The magnitude of overt hyperthyroidism 60 ranges from 0.2% to 1.3%; hypothyroidism ranges from 1% to 2%, rising with age in iodine- is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 5, 2022. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint Adherence to blood glucose testing: if the patient measured his blood glucose for more than 180 3 days in last seven days.

Adherence to diet: If patients followed recommended diet for more than 3 days in last 7 days. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 5, 2022. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint 

It was found that 67% of cases consume a healthy diet more than 3 times per week including 232 fruit, vegetables, high fiber diet, and low unsaturated fat; 72% of controls also do so. In is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint Regarding an unhealthy diet such as high-fat food, full-fat dairy products, 46.7% of cases and is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 5, 2022. (Table 4 ). is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint hypoglycemic agents used in 20.6% of cases versus 14.8% of controls. However, none of the 286 studied diabetic medications had statistically significant association (see Table 5 ). is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 5, 2022. This study assesses, the association of glycemic control with thyroid dysfunction, predictors 303 of thyroid dysfunction, and association of thyroid dysfunction with chronic diabetic 304 complications.

In this study degree of blood glucose control in diabetes patients with thyroid dysfunction is 307 poorer than controls as the mean glycated hemoglobin level was 10.32 ± 2.4% and it was 308 9.249 ± 2.3% in controls. The difference is statistically significant (p= 0.001) which 309 underlines the association of chronic hyperglycemia and thyroid dysfunction. A similar case- is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint As insulin resistance is thought to be central in the pathophysiology of the development of 316 thyroid dysfunction, the duration of diabetes has been considered to be an important risk for 317 thyroid dysfunction (more than 5 years) mainly in hypothyroidism. Our finding revealed that 318 T2DM patients with 5 to 10 years duration of diabetes had higher odds of developing thyroid 319 dysfunction than less duration. However, there is no association in this study [27, 14, 26] 320

In this study, females formed 65% of participants, and being female has 2.5 times the odds of is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint 

Since TD is associated with poor blood glucose control, it is expected to worsen and It is known that hypothyroidism and T2DM are independently linked to the development of 361 coronary artery disease. Studies reported thyroid dysfunction of all spectrums to have an 362 association with coronary artery disease. However, this study did not, which could be due to 363 the relatively small sample size. Further study, probably a prospective cohort study is needed . CC-BY 4.0 International license It is made available under a perpetuity.

is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint these drugs suppressing TSH secretion. Regardless, more study is necessary to justify its 378 association, since no study has discovered by the investigator. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 5, 2022. ; https://doi.org/10.1101/2022.02.03.22270379 doi: medRxiv preprint morbidity and mortality. Thus, screening for thyroid dysfunction in T2DM patients, 390 especially the female gender, needs to be done. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint

The copyright holder for this this version posted February 5, 2022. ; https://doi.org/10.1101/2022.02.03.22270379 doi: medRxiv preprint

Gender, race and 465 socioeconomic influence on diagnosis and treatment of thyroid disorders in the 466

Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

WHO Mean Body Mass Index (BMI)". World Health Organization. Retrieved

De interpretatie van de bepaling van thyreoïdstimulerend hormoon 471 (TSH) [The interpretation of the thyroid stimulating hormone (TSH) assay

Thyroid stimulating hormone 474 and free triiodothyronine are valuable predictors for diabetic nephropathy in patient 475 with type 2 diabetes mellitus

Thyroid Dysfunction and Cytological Patterns 478 among Patients Requested for Thyroid Function Test in an Endemic Goiter Area

Evaluation of thyroid function tests in 482 patients with uncontrolled type 2 diabetes mellitus

 415 We acknowledge Dire Dawa University, College of Medicine and Health Science, 416 Department of Public Health facilitating to conduct this study. Our heartfelt gratitude goes to 417 all study participants, all data collectors and health professionals in both hospitals for their 418 unreserved help and facilitation. Finally, we would like to appreciate Dr. Kedir Teji, Sister 419 Hanna Lambero and Nebiyu Damtew for their unreserved technical assistance. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprintThe copyright holder for this this version posted February 5, 2022. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprintThe copyright holder for this this version posted February 5, 2022. is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprintThe copyright holder for this this version posted February 5, 2022. ; https://doi.org/10.1101/2022.02.03.22270379 doi: medRxiv preprint