Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2024; 15(2): 209-219
Published online Feb 15, 2024. doi: 10.4239/wjd.v15.i2.209
Vitamin D, selenium, and antidiabetic drugs in the treatment of type 2 diabetes mellitus with Hashimoto's thyroiditis
Fen Feng, Bin Zhou, Ci-La Zhou, Ping Huang, Gang Wang, Kuang Yao
Fen Feng, School of Pharmacy, Shaoyang University, Shaoyang 422099, Hunan Province, China
Bin Zhou, Ci-La Zhou, Ping Huang, Gang Wang, Kuang Yao, Department of Endocrinology, The Central Hospital of Shaoyang, Shaoyang 422099, Hunan Province, China
Author contributions: Feng F and Zhou B jointly researched, wrote, and revised the paper; Zhou CL, Huang P, Wang G, and Yao K participated in the analysis and provided clinical advice.
Supported by Science and Technology Plan Project of Shaoyang City, No. 2022GX4139.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The Central Hospital of Shaoyang.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bin Zhou, MM, Chief Physician, Department of Endocrinology, The Central Hospital of Shaoyang, No. 36 Qianyuan Lane, Hongqi Road, Daxiang District, Shaoyang 422099, Hunan Province, China. zhoubin790921@163.com
Received: November 22, 2023
Peer-review started: November 22, 2023
First decision: December 8, 2023
Revised: December 16, 2023
Accepted: January 16, 2024
Article in press: January 16, 2024
Published online: February 15, 2024
Processing time: 74 Days and 1.8 Hours
Abstract
BACKGROUND

Diabetes and thyroiditis are closely related. They occur in combination and cause significant damage to the body. There is no clear treatment for type-2 diabetes mellitus (T2DM) with Hashimoto's thyroiditis (HT). While single symptomatic drug treatment of the two diseases is less effective, combined drug treatment may improve efficacy.

AIM

To investigate the effect of a combination of vitamin D, selenium, and hypo-glycemic agents in T2DM with HT.

METHODS

This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023. Fifty patients were assigned to the control group, test group A, and test group B according to different treatment methods. The control group received low-iodine diet guidance and hypoglycemic drug treatment. Test group A received the control treatment plus vitamin D treatment. Test group B received the group A treatment plus selenium. Blood levels of markers of thyroid function [free T3 (FT3), thyroid stimulating hormone (TSH), free T4 (FT4)], autoantibodies [thyroid peroxidase antibody (TPOAB) and thyroid globulin antibody (TGAB)], blood lipid index [low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triacylglycerol (TG)], blood glucose index [fasting blood glucose (FBG), and hemoglobin A1c (HbA1c)] were measured pre-treatment and 3 and 6 months after treatment. The relationships between serum 25-hydroxyvitamin D3 [25 (OH) D3] level and each of these indices were analyzed.

RESULTS

The levels of 25 (OH) D3, FT3, FT4, and LDL-C increased in the order of the control group, test group A, and test group B (all P < 0.05). The TPOAB, TGAB, TC, TG, FBG, HbA1c, and TSH levels increased in the order of test groups B, A, and the control group (all P < 0.05). All the above indices were compared after 3 and 6 months of treatment. Pre-treatment, there was no divergence in serum 25 (OH) D3 level, thyroid function-related indexes, autoantibodies level, blood glucose, and blood lipid index between the control group, test groups A and B (all P > 0.05). The 25 (OH) D3 levels in test groups A and B were negatively correlated with FT4 and TGAB (all P < 0.05).

CONCLUSION

The combination drug treatment for T2DM with HT significantly improved thyroid function, autoantibody, and blood glucose and lipid levels.

Keywords: Type-2 diabetes mellitus, Hashimoto's thyroiditis, Vitamin D, Selenium agent, Hypoglycemic drugs, Curative effect

Core Tip: Selenium yeast and active vitamin D can reduce thyroid-related antibodies in type-2 diabetes mellitus (T2DM) and Hashimoto's thyroiditis (HT) and improve thyroid function. Hypoglycemia drugs can lower blood sugar levels in patients and promote blood sugar stability. While most patients with T2DM and HT are currently treated with a single symptomatic drug, the effects are unsatisfactory. In this study, the combination of vitamin D and selenium yeast added to hypoglycemic agents to treat T2DM patients with HT showed a remarkable therapeutic effect.