Type 2 diabetic patients with Graves' disease have more frequent and severe Graves' orbitopathy.

Nutr Metab Cardiovasc Dis

Department of Clinical and Molecular Biomedicine, Endocrinology Unit, Garibaldi-Nesima Medical Center, University of Catania, Via Palermo 636, 95100 Catania, Italy; National Research Council (CNR), Department of Biostructures and Bioimmaging, Catania, Italy.

Published: May 2015

AI Article Synopsis

  • The study investigates the relationship between Graves' disease (GD), Graves' orbitopathy (GO), and diabetes mellitus (DM), revealing a strong association between GD and Type 1 DM (T1DM) but not Type 2 DM (T2DM).
  • GO is found to be more prevalent and severe in patients with T2DM, indicating that T2DM is a significant risk factor for severe GO.
  • Factors such as diabetes duration, obesity, and vascular complications influence the severity of GO, while metabolic control does not appear to have a significant effect.

Article Abstract

Background And Aims: Due to the worldwide increasing prevalence of diabetes (DM), patients with both diabetes and Graves' disease (GD) have become more frequent. Sporadic reports indicate that Graves' orbitopathy (GO), a GD complication that affects orbital soft tissues, can be severe in DM patients. The relationship between these diseases is not well understood. This study aims at evaluating the association of GD and GO with autoimmune and non-autoimmune diabetes (DM) and to assess diabetic features that influence GD and GO prevalence and severity.

Methods And Results: This retrospective study evaluated GD, GO and DM association in 1211 consecutive GD patients (447 with GO and 77 with DM). A case-control study was carried out to evaluate DM relationship with GO severity by comparing at 1:2 ratio GO patients with or without DM. A strong association was found between GD and T1DM (p = 0.01) but not T2DM. Instead, the presence of GO was strongly associated with T2DM (p = 0.01). Moreover, GO was more frequently severe in GD patients with T2DM (11/30 or 36.6%) than in those without T2DM (1/60 or 1.7%, p = 0.05). T2DM was the strongest risk factor for severe GO (OR = 34.1 vs. 4.4 p < 0.049 in cigarette smokers). DM duration, obesity and vascular complications, but not metabolic control were significant determinants of GO severity.

Conclusions: GD is associated with T1DM but not with T2DM, probably because of the common autoimmune background. GO, in contrast, is more frequent and severe in T2DM, significantly associated with obesity, diabetes duration and diabetic vasculopathy but not metabolic control.

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http://dx.doi.org/10.1016/j.numecd.2015.01.003DOI Listing

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