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
- 12월-2021
- Publisher
- KOREAN ENDOCRINE SOC
- Keywords
- Hyperthyroidism; Graves disease; Diabetes mellitus; Antithyroid agents; Radioiodine ablation
- Citation
- ENDOCRINOLOGY AND METABOLISM, v.36, no.6, pp.1277 - 1286
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- ENDOCRINOLOGY AND METABOLISM
- Volume
- 36
- Number
- 6
- Start Page
- 1277
- End Page
- 1286
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/135640
- DOI
- 10.3803/EnM.2021.1251
- ISSN
- 2093-596X
- 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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