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A Case-Based Guide to Clinical EndocrinologyHashimoto’s Thyroiditis and Type 1 Diabetes

A Case-Based Guide to Clinical Endocrinology: Hashimoto’s Thyroiditis and Type 1 Diabetes Chapter 10 Mark P.J. Vanderpump Objectives This case history illustrates the diagnosis of chronic autoimmune goitrous (Hashimoto’s) thyroiditis and the management of subclinical hypothyroidism in a young woman with type 1 diabetes. It then addresses the evidence for an association between autoimmune thyroiditis and type 1 diabetes and the current known genetic factors, as well as the importance of screening for autoimmune thyroiditis in patients with type 1 diabetes. Case Presentation A 26-year-old woman with type 1 diabetes worked in the City (the financial district of London) as a trader. She had recently moved to London. She had been diag- nosed 2 years earlier, after having initially presented as an emergency with diabetic ketoacidosis. She had been stabilized on a “qds” insulin regime with a short-acting insulin analogue before meals and a long-acting analogue at night. She was on the oral contraceptive pill and not considering starting a family in the next few years. She was a nonsmoker. The relevant family history included an uncle with myasthenia gravis and a grandmother on thyroxine replacement for long-standing hypothyroidism. Her most recent hemoglobin A1c(HbA1c) was 7.6%. There was no significant dyslipidemia, her blood pressure was 124/76, and there was no evi- http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologyHashimoto’s Thyroiditis and Type 1 Diabetes

Part of the Contemporary Endocrinology™ Book Series
Editors: Davies, Terry F.
Vanderpump, Mark P.J.
A Case-Based Guide to Clinical Endocrinology — Jan 1, 2008
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Publisher
Humana Press
Copyright
© Humana Press,Totowa, NJ 2008
ISBN
978-1-58829-815-7
Pages
93 –99
DOI
10.1007/978-1-60327-103-5_10
Publisher site
See Chapter on Publisher Site

Abstract

Chapter 10 Mark P.J. Vanderpump Objectives This case history illustrates the diagnosis of chronic autoimmune goitrous (Hashimoto’s) thyroiditis and the management of subclinical hypothyroidism in a young woman with type 1 diabetes. It then addresses the evidence for an association between autoimmune thyroiditis and type 1 diabetes and the current known genetic factors, as well as the importance of screening for autoimmune thyroiditis in patients with type 1 diabetes. Case Presentation A 26-year-old woman with type 1 diabetes worked in the City (the financial district of London) as a trader. She had recently moved to London. She had been diag- nosed 2 years earlier, after having initially presented as an emergency with diabetic ketoacidosis. She had been stabilized on a “qds” insulin regime with a short-acting insulin analogue before meals and a long-acting analogue at night. She was on the oral contraceptive pill and not considering starting a family in the next few years. She was a nonsmoker. The relevant family history included an uncle with myasthenia gravis and a grandmother on thyroxine replacement for long-standing hypothyroidism. Her most recent hemoglobin A1c(HbA1c) was 7.6%. There was no significant dyslipidemia, her blood pressure was 124/76, and there was no evi-

Published: Jan 1, 2008

Keywords: Celiac Disease; Reference Range; Subclinical Hypothyroidism; Thyroid Function Test; Autoimmune Thyroiditis

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