Summary
Basal and TRH-stimulated thyroid hormones and TSH were evaluated in two groups of
prepubertal and pubertal diabetics: group B-45 children without ketoacidosis; group
C - 16 children with ketoacidosis. The diabetic patients showed no signs of diabetic
microangiopathy. Fifty-three healthy subjects served as controls (group A). T4, T3, FT4 and FT3 serum levels were reduced in diabetics, particularly in ketotic ones; T4 and T3 values were lower in pubertal than in prepubertal non-ketotic diabetics and in pubertal
than in prepubertal controls, while no significant difference was observed between
pubertal and prepubertal ketotic patients. Moreover, no difference in rT3 serum concentrations was found between group A, B and C, but non-ketotic and ketotic
pubertals showed a significant rT3 reduction if compared with non-ketotic and ketotic prepubertals and with healthy
pubertals. TBG was lower in group B and group C diabetics than in controls. After
TRH stimulus, T3 levels showed a significant increase both in controls and in non-ketotic diabetics,
while no variation was observed in ketotic children; furthermore, at 120 minutes T3 values were lower in diabetic than in healthy children, particularly in ketotic ones.
Basal TSH serum concentrations were reduced in ketotic diabetics, while no difference
was found between nonketotic and control subjects. After TRH stimulus, TSH peak was
higher in pubertal non-ketotic diabetics than in pubertal controls, while no difference
was found between prepubertal and pubertal diabetics, both in non-ketotic and in ketotic
status.
The data clearly show that metabolic control affects thyroid function and hypothalamic-pituitary-thyroid
axis in insulin-dependent diabetic children and adolescents; during diabetic ketoacidosis
the derangement of thyroid hormones is impressive. Puberty modifies peripheral thyroid
metabolism both in diabetics and in normal children.
Key-Words
Thyroid Hormones - Insulin-Dependent Diabetes Mellitus - Puberty - Ketoacidosis
