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A clinical case of a patient with subclinical hypothyroidism and newly diagnosed diabetes mellitus and arterial hypertension

Elena Marinova, Mariya Dimova, Krasimira Nenova, Liliya Stoyanova


Diabetes mellitus and hypothyroidism are the most common endocrine disorders and when concomitant in the same patient can change the course of each conditions in a rather different way than when running their course on their own. Both hormones - insulin and the thyroid hormone, act on cell metabolism and the excess or insufficient secretion of any of them affects the function of the other. In clinical practice, it is very useful to be familiar with the interaction between these two hormones for better screening and management of the diseases. It is well known that a single hormone dysfunction can change other hormone activity. It is the situation in hyper- or hypothyroidism, both influence blood glucose level and that should be taken into account when biochemistry is analyzed. On the other hand, diagnosing diabetes mellitus, especially the autoimmune form of the disease, directs our attention toward searching for another autoimmune disorder like Hashimoto thyroiditis. Here, we present a clinical case of a female patient with hypertensive crises with unestablished arterial hypertension, in whom additional concomitant disorders - thyroid dysfunction and diabetes mellitus, were diagnosed simultaneously. We discuss the approach to the diagnosis and target organ evaluation, as well as the management of the diseases in the light of the newest guidelines.


subclinical hypothyroidism; diabetes mellitus; hypertension

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Pearce SHS, Brabant G, Duntas LH, et al. 2013 ETA Guideline: Management of Subclinical Hypothyroidism.European Thyroid Journal. 2013;2(4):215-228. doi:10.1159/000356507.

Melanie J.Davies,David A.D’Alessio,JudithFradkin, Walter N.Kernan Chantal Mathieu, Geltrude Mingrone, Peter Rossing, ApostolosTsapas, Deborah J. Wexler,John B. Buse Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Diabetes Care Sep 2018, dci180033; DOI:10.2337/dci18-0033

Williams B, Mancia G, 2018 ESC/ESH Guidelines for themanagement of arterial hypertension, European Heart Journal (2018) 00, 1–98 doi:10.1093/eurheartj/ehy339

Chaoxun Wang, The relationship between Type 2 Diabetes mellitus and Related Thyroid Diseases, Journal of Diabetes Research Volume 2013, Article ID 390534, 9 pages


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