Latent Autoantibodies and AssociatedThyroid Disorders in Clinically Diagnosed Type II Diabetes mellitus

Abstract

This study was carried out in three centers, Ribat University Hospital (Khartoum), Bahri Diabetic Center (Khartoum North) and ImtyazDiabetic Center (Omdurman). The main aims of this study were to investigate the presence of islet cell autoantibodies, differentiate between insulin dependence and insulin independence as well as to diagnose the prevalence of thyroid disorders among diabetes mellitus type two patients. Blood samples were taken from eighty eight(88) Sudanese type II diabetic patients (represented as 57.2% were female while 41.8% were males) and forty(40) apparently healthy individualsas control group as 50% for both sexes. The mean age was (50.3) and (48.7)years for the patients and the control groups respectively ranged between (40-65) year. Out of the total patients, 69.3% have family history of diabetes. The duration of the disease ranged between 1-10 years. All of the patients received oral treatment (Insulin independence). Pancreatic autoantibodies were detected by using the Enzyme Linked Immuno Sorbant Assay (ELISA). To estimate the level of the thyroid hormones (T3 & T4) and the thyroid stimulating hormone (TSH) among diabetic patients, Radio Immune Assays (RIA/ IRMA) techniques were used to determine the relation between diabetes mellitus and thyroid gland disorders. The FBG was measured colourimetrically. A significant increase (p= 0.00) in FBG level was observed among the patients compared to the healthy subjects. Pancreatic autoantibodies were detected in 9 patients (10.2%), but no evidence of a relation between Fasting Blood Sugar IV (FBG) level and the pancreatic autoantibodies detected. Out of the 9 patients examined, 3 of them were shown to have thyroid disorders. When the thyroid disorders were screened, 24 patients (27.3%) were found to have clinical, subclinical, hypo or hyper thyroidism from all the patients. Furthermore, TSH level(0.01) in patients with type II DM was significant low compared to the healthy group. There was a significant negative correlation between the FBG level and TSH hormone (0.038) while no correlation observed between FBG level and the T3 and T4. This study concluded that patients with blood glucose disturbances should examine pancreatic autoantibodies to differentiate the type of DM in order to choose the appropriate treatment. Further more, it is important to investigate the thyroid hormones and TSH annually to determine the clinicaland subclinical dysfunctions for the possible early treatment and control of endocrine disorders