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We focussed on articles published between 2000 and 2010 but did not exclude commonly referenced and highly regarded older publications.



Both DM and thyroid dysfunction may affect the health of mother and foetus and impact on obstetric care.

Most importantly, and explained by decreased gluconeogenesis, hypothyroid patients with T1DM carry a higher risk of hypoglycaemic episodes.

However, higher prevalence of thyroid dysfunction in both type 1 and type 2 diabetes have been reported [1, 2].





As successful correction of hypothyroidism necessitates an increase in insulin dose, associated pituitary or adrenal failure should be considered in these patients.Metformin, an oral antidiabetic compound, is regarded as a first‐line drug for treatment of T2DM as it was shown to reduce mortality among overweight patients with DM and also when used for secondary prevention.Metformin acts primarily by suppressing hepatic gluconeogenesis via activation of AMPK, a prerequisite for the drug’s inhibitory effect at the hepatic level.In rat experiments, metformin has recently been shown to cross the blood–brain barrier and its concentrations in the hypothalamus match the levels in plasma. The present review will discuss these concepts and their consequences for the clinical care of patients with diabetes mellitus and thyroid disorders.



Interestingly, metformin levels in the pituitary gland are substantially increased.These studies reveal a suppressive effect of metformin on TSH secretion patterns in hypothyroid patients, an effect that is apparently independent of T4 treatment and does not alter the TH profile. It appears that better definition of the interactions between DM and thyroid hormones is necessary to optimize treatment of patients with diabetes mellitus.





Both diabetes mellitus and thyroid diseases are very common in the fields of endocrinology and metabolism.

The mechanism is not clear and several hypotheses have been postulated.The close interactions between thyroid status and metabolic control discussed above argue for close monitoring of thyroid function particularly in patients with T1DM.
The high prevalence of thyroid dysfunction, particularly in type 1 diabetes mellitus, should result in regular screening of thyroid function.We searched PubMed with any combination of the terms ‘thyroid disease’, ‘thyroid autoimmunity’, ‘hypothyroidism’, ‘hyperthyroidism’ and ‘diabetes mellitus’, ‘insulin resistance’, ‘glucose production’, ‘glucose output’ for the clinical part of the review. A high prevalence of TD is seen among both type 1 (T1DM) and type 2 (T2DM) diabetes mellitus patients [1, 2].






There are large variations in the different guidelines, ranging from ignoring thyroid function tests to yearly testing (reviewed in Ref. For the pathophysiological section, we included pathway‐specific data and review articles.Please check your email for instructions on resetting your password. An association between diabetes and thyroid disease has long been recognized, although the reported prevalence of thyroid dysfunction in diabetic populations varies widely between studies (10–18).

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