The Prevalence of Hypothyroidism in Patients with Type 2 Diabetes Mellitus in Saudi Community based Hospital a Retrospective Single Centre Study

Abstract

Background and Objective The association between diabetes and thyroid dysfunction were studied. To estimate retrospectively the frequency of hypothyroidism in patients with type 2 diabetes (T2DM) in Saudi community-based hospital. Design We analyzed retrospectively 3760 participants whom are between the age 20 to 98 years. All patients were from the population of the Primary health centre at King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. All data were collected on the basis of a review of electronic medical data. Patients with TSH above the normal range of TSH for our laboratory reference (4.2 MIU/L, history of hypothyroidism and taking thyroid replacement therapy were included. Patient who are pregnant were excluded. Results Out of the initial screening of 6023 subjects, 3760 subjects were included. There were 861 (22.9%) male and 2899 (77.1%) were female with mean age 44.9±15.8. The mean TSH value was 4.3±8.1. Among them we found 1521 (40.7%) and 1086 (28.9%) cases with T2DM and hypothyroidism respectively. Among cases of T2DM, there were 467 (30.7%) with hypothyroidism. There were 86 (18.4%) cases were male and 381 (81.6%) were female with male to female ratio of 1 to 4.4, p<0.0001. Cases with hypothyroidism were nonsignificantly older than cases with no hypothyroidism, 55.2±12.6 vs. 54.9±13.2 respectively, p=0.6. Cases with hypothyroidism were nonsignificantly showed no differences in HbA1c than cases with no hypothyroidism, 7.9±2.3 vs. 8.1±2.1 respectively, p=0.2. Hypothyroidism was more prevalent in the sixth decade (32%), figure 1. Hypothyroidism was significantly more prevalent in females between the third to the seventh decades as compared to males. Male was no significantly more prevalent than females in the eighth and ninth decades. Conclusion We conclude that despite the limitations of this hospital-based retrospective study, hypothyroidism is highly prevalent in cohort of Saudis with T2DM. The majority of our patients with primary hypothyroidism were predominantly females. These two observations remain to be validated by population-based studies. In the absence of registry data, larger cooperative studies involving diverse population samples from multiple centers could help to provide further information on the true frequency nationally. Based on a high prevalence of hypothyroidism among Saudi T2DM patients, routine screening for hypothyroidism is highly recommended in Saudi diabetic population.