Thyroid and Diabetes

The thyroid gland is one of the most significant organs of the human body, as it is in charge of regulating various bodily functions. Starting from metabolism and heart rate to mood and digestion, this small gland controls everything by secreting the necessary hormones. Now, when any disturbance causes this gland to produce excessive or inadequate hormones, it is regarded as a thyroid disorder.

Now, thyroid disorders further lead to diabetes, which is a medical condition when the body cannot produce or utilise sufficient insulin. As a result, the blood sugar level increases and leads to one of the two types of diabetes, type 1 diabetes (T1DM) and type 2 diabetes (T2DM). 

Now, thyroid disorders and diabetes are both interrelated. Thyroid disorder injures glucose metabolism, which leads to uncontrolled blood sugar levels, i.e. diabetes.

So, let's understand what happens when thyroid and diabetes coexist.

Relationship between Thyroid Disorders and Diabetes 

Thyroid dysfunction affects glucose metabolism in diabetic patients by altering metabolism and insulin regulation. Due to hypothyroidism, the glucose metabolism slows down, which, in turn, leads to insulin resistance and high blood sugar. Alternatively, with hyperthyroidism, the glucose in the body burns faster, leading to low blood sugar. Either way, they hamper the hormonal balance, complicate diabetes management and increase the risk of blood sugar fluctuations.

Impact of diabetes on thyroid health

• Diabetes can interfere with metabolism. Thus, it further affects thyroid hormone production and its functionalities. Diabetes can also change the TSH level and interrupt the conversion of T4 to T3. 
• Insulin resistance and hyperinsulinemia increase the chance of thyroid nodules, which then leads to goitre.
• T2DM patients have the risk of an increment in thyroid tissue hyperplasia. As a result, the thyroid gland becomes larger and starts developing nodules. 

Common Thyroid Disorders in Diabetes

Here is how common thyroid disorders can affect diabetes –

Hypothyroidism and its effects on diabetes

• Low metabolism 
• Insulin resistance 
• Haemoglobin A1C (HbA1C) Increment 

Hyperthyroidism and its effects on diabetes

• Boost insulin breakdown 
• Altered glucose metabolism 

Symptoms of Coexisting Thyroid and Diabetes Conditions

The co-existence of diabetes and thyroid can be easily identified by the following symptoms –

• Weakness
• Anxiety and irritability
• Unusual weight
• Muscle weakness
• Sleeping disorder

Other unique symptoms that may arise from coexisting conditions are –

• Muscle cramps
• Feeling cold
• Poor memory
• Hoarse voice
• Dry skin

Diagnostic Procedures

The diagnosis process of this co-existence has two facets. Here are they –

Thyroid tests for diabetes patients

• Thyroid function test (TFT): It helps doctors to identify diabetes with unusual thyroid hormone status. Also, it can reveal the complications related to type T2DM. 
• Thyroid antibodies test: It measures several thyroid antibodies. Specifically helpful for finding out autoimmune thyroid disorders. 

Furthermore, some imaging tests to determine this condition include –

• CT scans
• Nuclear medicine tests
• Ultrasound

Diabetes tests for individuals with thyroid disorders

• HbA1C test: It measures the average blood glucose level for the last 3 months. 
• Fasting plasma glucose (FPG) test: It measures blood glucose at a single time. 
• Oral glucose tolerance test: The doctors use this test to detect T2DM, gestational diabetes, and prediabetes.
• Random plasma glucose test: The doctors conduct this test whenever the patient has symptoms of diabetes.

Treatment and Management

The treatment and management of these two conditions need a comprehensive approach that includes medication and lifestyle changes. Here are the details –

Medications for thyroid and diabetes

Medications for thyroid -

• Levothyroxine
• Antithyroid drugs like propylthiouracil and methimazole
• Beta-blockers 

Medications for diabetes -

• Meglitinides
• Sulfonylureas
• Thiazolidinediones

Lifestyle changes that benefit both conditions

• Avoid foods with high sugar and fat components. Also, eat adequate vegetables, fruits, protein, and whole grains and keep a limit on carbohydrate intake. These help both diabetes and thyroid patients. 
• Engage in physical activities such as walking, cycling, etc. These help in controlling blood pressure, A1C, and cholesterol. 
• Stress and anxiety increase blood sugar levels. Getting rid of it with yoga, meditation, and deep breathing techniques helps. 
• Limit alcohol to control diabetes and thyroid.
• Stop smoking as it can harm the heart, nerves, blood vessels, kidneys, etc. 

Monitoring and managing complications

• Blood sugar monitoring
• Thyroid function test - measuring T4, T3, and TSH levels
• HbA1C test - measuring blood sugar level for the past 2-3 months
• Medication for diabetes - insulin or oral medication
• Medications for thyroid - regulating thyroid hormone levels
• Regular check-ups - monitoring diabetes and thyroid
• Diet and exercise

Lifestyle and Dietary Recommendations

Here are some lifestyle and dietary changes that patients can make to manage both the conditions –

Diet modifications

Foods for diabetes -

• Non-starchy vegetables: Carrots, mixed green salads, squash 
• Protein foods: Eggs, fish, lean meat
• Carbohydrate foods: Whole grains, yoghurt, milk

Foods for hypothyroidism -

• Iodine-rich foods: Iodised salt, seafood 
• Selenium-rich foods: Eggs, Brazil nuts, tuna
• Zinc-rich foods: Poultry foods, oysters

Foods for hyperthyroidism -

• Low-iodine foods: Non-iodised salt, oats, fresh fruits
• Cruciferous vegetables: Cauliflower, bamboo shoots, kale
• Calcium: Spinach, almond milk, white beans

Exercise recommendations

• Walking
• Yoga
• Meditation
• Tai chi
• Team sports
• Swimming

Stress management techniques

The following stress management techniques are helpful for both diabetes and thyroid patients.

• Get plenty of sleep. 
• Perform relaxation exercises. 
• Perform deep breathing techniques. 
• Listen to music.
• Engage in hobbies such as painting, reading, gardening, etc. 

Complications of Untreated Conditions

In case someone decides to leave these conditions untreated, there here are some complications he/she can experience in the long run –

• Cardiovascular issues
• Kidney damage
• Mental health issues - depression and anxiety
• Bone loss/ osteoporosis
• Neurological complications - nerve damage, tingling, etc.

Therefore, to deal with diabetes and thyroid together, a timely medical check-up is mandatory. Additionally, regular monitoring and follow-ups help physicians understand the treatment's effectiveness. They can monitor if the medications are working properly and then adjust the dosage accordingly.

Recent Research and Developments

Recent research highlights a strong connection between thyroid dysfunction and diabetes, revealing that thyroid disorders are more prevalent among individuals with diabetes than in the general population. A study involving 1,310 adult diabetes patients found that 13.4% had thyroid disease. Among them, 31.4% were individuals with type 1 diabetes, while 6.9% had type 2 diabetes, underscoring the significant overlap between these conditions.

At the same time, there have been advancements in the treatment options for these two conditions. Some examples are –

• Advanced imaging techniques like ultrasound, nuclear medicine scans
• Therapies like thyroid hormone replacement 
• Radiofrequency ablation 
• Minimally invasive surgeries

Conclusion

Medical evidence establishes the interconnection between thyroid and diabetes. So, patients suffering from one condition must check for the other and see if they are coexisting or not.  Depending on the result, they need to consult with the physicians and get treated for both. At the same time, they must alter their diet and inculcate some lifestyle changes to further their recovery. All in all, it is not impossible to manage these conditions, but neglecting one can worsen the other, leading to further health complications.