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Thyroid Function of Hyperthyroidism Sugar Metabolism Influence and Clinical Significance

Author: WenJie
Tutor: SunLiJuan
School: Jilin University
Course: Internal Medicine
Keywords: Hyperthyroidism glucose metabolism Type2diabetes mellitus Intensive therapy islet function
CLC: R587.1
Type: Master's thesis
Year: 2012
Downloads: 133
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Abstract


Hyperthyroidism and diabetes is more common endocrine disease.Thecoexistence of the two more often, and trends in morbidity hasincreased year by year.Clinic, graves ’ disease in patients withimpaired glucose tolerance and diabetes mellitus are more common.Havemade many documents, abnormal glucose metabolism in hyperthyroidism,but the specific mechanism is not yet clear, different ways ofexpressing ideas, this article on hyperthyroidism on glucosemetabolism and insulin hypoglycemic programme on the impact ofhyperthyroidism complicated with type2diabetes mellitus patientswith pancreatic islet function in discussion.Thus, in clinical work,for the understanding and treatment of hyperthyroidism complicatedwith diabetes programme selection provides a more extensive basis.January2010-October2011this study randomly selected hospitaladmitted to70patients with hyperthyroidism and normal control groupof35cases, detection of insulin (Fins), fasting plasma glucose (FPG),2H after oral glucose tolerance test glucose (OGTT2hPG), calculatethe insulin index (HOMA-IR), insulin sensitivity index (ISI),pancreatic islet beta cells function index (HOMA-IS) and compared.Then on23cases of hyperthyroidism complicated withdiabetic patients;Select25patients with newly diagnosed diabetesthat is not complicated with hyperthyroidism as a control group, groupof hyperthyroidism complicated with diabetes mellitus, oraladministration of methimazole or propyl thiouracil;Two groups aremade of short-term insulin (insulin preserved Lai) subcutaneousinjection before meals,21:00long-acting insulin (insulin glargine)subcutaneous injection, according to blood glucose monitoring toadjust insulin doses, blood sugar after the standard maintenancetreatment, course of treatment is3weeks.Take on an empty stomachfor all venous blood, determination of blood glucose and postprandial2H glucose, glycosylated hemoglobin (HbA1c) free three iodine thyroid,heart rate, the original amino acid (FT3), free thyroxine (FT4), serumthyroid stimulating hormone (TSH) checks, intensive insulin therapybefore and after fasting c-peptide (PC-P),2hours after a meal ofc-peptide (P2hC-P).This use of spss17.0software for dataprocessing.Measurement information adopted±s, comparison databetween the groups using t test, ISI, HOMA-IR, and HOMA-IS for thenon-normal distribution, whichever standard of testing statisticalanalysis of natural logarithms α=0.05.Clinical observation in two groups and found that (1) the firstset of hyperthyroidism complicated with metabolic disorders found in clinical studies (51.43%), which reduced glucose tolerance (IGT)(34.29%), impaired fasting glucose (IFG)(5.71%), diagnostic criteriafor diabetes mellitus (11.43%), hyperthyroidism group OGTT2hPG,Insulin (HOMA-IR) significantly above the normal control group(P<0.05);Insulin sensitivity index (ISI), pancreatic islet beta cellsfunction index (HOMA-IS) is lower than the control group (P<0.05).(2)clinical research by taking the second set after the methimazole orpropyl thiouracil, clinical group FT3, FT4, significantly lower inpatients with hyperthyroidism complicated with diabetes mellitus,heart rate lowered to normal range, representing a differencestatistically significant treatment earlier (P<0.001).Two groups ofpatients with FPG,2hPG is notably controls, difference statisticallysignificant comparison before and after treatment (P<0.001).Twogroups of patients with insulin when blood glucose targets are large,and the amount of hyperthyroidism complicated with diabetes groupgreater, a simpler comparison diabetes group differences arestatistically significant (P<0.001).Treatment of hyperthyroidismcomplicated with diabetic insulin dosage group after3weeks when moreblood glucose targets to reduce significantly, compared the twodifferences are statistically significant (P<0.001).In the two groupsafter treatment fasting c-peptide and insulin therapy earlier did notsignificantly change (P>0.05), and after glucose loading a significant phase of c-peptide secretion, a significant increasecompared with before treatment, the difference statisticallysignificant (P<0.05), but hyperthyroidism complicated with diabetesDiabetes Group increased less than simple groups.Through this set of data results, taking into account theprogress of the experts at home and abroad, we come to the followingconclusions:(1) thyroid hormones can affect glucose metabolism,abnormal glucose metabolism and insulin resistance in patients withhyperthyroidism often exist.(2) Hyperthyroidism complicated withpoor blood sugar control in patients with type2diabetes should bestrengthened as soon as possible diabetes programme, intensivehypoglycemic therapy can improve with poor blood sugar control in type2diabetes mellitus patients with hyperthyroidism of pancreatic betacell function, and can be fast and stable control of blood glucose,be aware of dosage should be relatively simple in the early treatmentof diabetic patients was on the high side.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Islet disease > Diabetes
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