Review
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2024; 15(3): 348-360
Published online Mar 15, 2024. doi: 10.4239/wjd.v15.i3.348
Association of autoimmune thyroid disease with type 1 diabetes mellitus and its ultrasonic diagnosis and management
Jin Wang, Ke Wan, Xin Chang, Rui-Feng Mao
Jin Wang, Xin Chang, Department of Ultrasound Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing 211200, Jiangsu Province, China
Ke Wan, Faculty of Medicine and Health, The University of Sydney, Camperdown NSW 2050, Australia
Rui-Feng Mao, School of Life Science, Huaiyin Normal University, Huai'an 223300, Jiangsu Province, China
Author contributions: Wang J, Wan K, Chang X, and Mao RF contributed to conceptualization and writing-review and editing; all authors have read and agreed to the published version of this manuscript.
Supported by Medical Education Collaborative Innovation Fund of Jiangsu University, No. JDYY2023101.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
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: Xin Chang, PhD, Chief Physician, Professor, Department of Ultrasound Medicine, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, No. 86 Chongwen Road, Lishui District, Nanjing 211200, Jiangsu Province, China. changxinnj@163.com
Received: October 25, 2023
Peer-review started: October 25, 2023
First decision: December 8, 2023
Revised: December 14, 2023
Accepted: January 18, 2024
Article in press: January 18, 2024
Published online: March 15, 2024
Abstract

As a common hyperglycemic disease, type 1 diabetes mellitus (T1DM) is a complicated disorder that requires a lifelong insulin supply due to the immune-mediated destruction of pancreatic β cells. Although it is an organ-specific autoimmune disorder, T1DM is often associated with multiple other autoimmune disorders. The most prevalent concomitant autoimmune disorder occurring in T1DM is autoimmune thyroid disease (AITD), which mainly exhibits two extremes of phenotypes: hyperthyroidism [Graves' disease (GD)] and hypo-thyroidism [Hashimoto's thyroiditis, (HT)]. However, the presence of comorbid AITD may negatively affect metabolic management in T1DM patients and thereby may increase the risk for potential diabetes-related complications. Thus, routine screening of thyroid function has been recommended when T1DM is diagnosed. Here, first, we summarize current knowledge regarding the etiology and pathogenesis mechanisms of both diseases. Subsequently, an updated review of the association between T1DM and AITD is offered. Finally, we provide a relatively detailed review focusing on the application of thyroid ultrasonography in diagnosing and managing HT and GD, suggesting its critical role in the timely and accurate diagnosis of AITD in T1DM.

Keywords: Type 1 diabetes mellitus, Autoimmunity, Autoimmune thyroid disease, Ultrasonography, Diagnosis

Core Tip: Although type 1 diabetes mellitus (T1DM) is an organ-specific autoimmune disease, patients with this disease are more prone to develop other autoimmune disorder, and the most prevalent autoimmune disorder in T1DM patients is autoimmune thyroid disease (AITD). Undiagnosed and untreated AITD may lead to metabolic disturbances and impair diabetes care in T1DM patients, warranting regular and long-term observation. We herein offer an updated review of the basic characteristics of both diseases and factors contribute to their concomitant presence. Additionally, we focus on the role of thyroid ultrasonography in the diagnosis and management of AITD.