Risk of Diabetes in Patients with Long-Standing Graves' Disease: A Longitudinal Study
- Authors
- Song, Eyun; Koo, Min Ji; Noh, Eunjin; Hwang, Soon Young; Park, Min Jeong; Kim, Jung A; Roh, Eun; Choi, Kyung Mook; Baik, Sei Hyun; Cho, Geum Joon; Yoo, Hye Jin
- Issue Date
- Dec-2021
- Publisher
- 대한내분비학회
- Keywords
- Hyperthyroidism; Graves disease; Diabetes mellitus; Antithyroid agents; Radioiodine ablation
- Citation
- Endocrinology and Metabolism, v.36, no.6, pp 1277 - 1286
- Pages
- 10
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Endocrinology and Metabolism
- Volume
- 36
- Number
- 6
- Start Page
- 1277
- End Page
- 1286
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/55076
- DOI
- 10.3803/EnM.2021.1251
- ISSN
- 2093-596X
2093-5978
- Abstract
- Background
The detrimental effects of excessive thyroid hormone on glucose metabolism have been widely investigated. However, the risk of diabetes in patients with long-standing hyperthyroidism, especially according to treatment modality, remains uncertain, with few longitudinal studies.
Methods
The risk of diabetes in patients with Graves’ disease treated with antithyroid drugs (ATDs) for longer than the conventional duration (≥2 years) was compared with that in age-and sex-matched controls. The risk was further compared according to subsequent treatment modalities after a 24-month course of ATD: continuation of ATD (ATD group) vs. radioactive iodine ablation (RIA) group.
Results
A total of 4,593 patients were included. Diabetes was diagnosed in 751 (16.3%) patients over a follow-up of 7.3 years. The hazard ratio (HR) for diabetes, after adjusting for various known risk factors, was 1.18 (95% confidence interval [CI], 1.10 to 1.28) in patients with hyperthyroidism. Among the treatment modality groups, the RIA group (n=102) had a higher risk of diabetes than the ATD group (n=4,491) with HR of 1.56 (95% CI, 1.01 to 2.42). Further, the risk of diabetes increased with an increase in the ATD treatment duration (P for trend=0.019).
Conclusion
The risk of diabetes was significantly higher in patients with long-standing Graves’ disease than in the general population, especially in patients who underwent RIA and prolonged ATD treatment. Special attention to hyperglycemia during follow-up along with effective control of hyperthyroidism may be necessary to reduce the risk of diabetes in these patients.
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Collections - 2. Clinical Science > Department of Obstetrics and Gynecology > 1. Journal Articles
- 5. Others > Medical Science Research Management Center > 1. Journal Articles
- 2. Clinical Science > Department of Endocrinology and Metabolism > 1. Journal Articles
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