Background

United Kingdom national guidelines do not recommend routine testing for thyroid disease in people with type 2 diabetes mellitus (T2DM). However, some studies suggest an increased risk of thyroid dysfunction in T2DM. The aim of this study was to evaluate the current practice of screening for thyroid disease in patients with T2DM.

Methods

Patients with pre-existing T2DM (n = 339) were selected from records for routine glycated haemoglobin testing performed in December 2008. Using routinely collected primary/secondary care data from 2009 to 2017, we examined longitudinal thyroid-stimulating hormone and free thyroxine requests to determine the overall proportion of patients screened for thyroid dysfunction and the time interval between thyroid tests requested.

Results

Thirty-three patients (9.7%) had pre-existing thyroid disease. Of the remaining 306 patients, 96.4% had at least one thyroid test during the follow-up period. When the time interval between tests was evaluated in these patients, there was a discrete peak in thyroid function test requests at 12 months, consistent with routine annual testing. Most requests (77%) originated from a general practice setting.

Conclusions

Contrary to current guidelines, we have provided evidence suggestive of regular screening for thyroid dysfunction in patients with T2DM, particularly in general practice. The appropriateness of this practice remains unclear, but may warrant further examination to assess the clinical benefits of screening, balanced against cost.

中文翻译：

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在2型糖尿病患者中筛查甲状腺疾病：对当前实践的评估。

背景

英国国家指南不建议对2型糖尿病（T2DM）人群的甲状腺疾病进行常规检测。但是，一些研究表明，T2DM中甲状腺功能障碍的风险增加。这项研究的目的是评估目前筛查T2DM患者甲状腺疾病的实践。

方法

 从2008年12月进行的常规糖化血红蛋白测试的记录中选择已存在T2DM的患者（n = 339）。使用2009年至2017年常规收集的初级/二级护理数据，我们检查了纵向甲状腺刺激激素和对甲状腺激素的免费要求确定筛查甲状腺功能障碍的患者的总体比例以及要求进行两次甲状腺检查之间的时间间隔。

结果

三十三名患者（9.7％）患有甲状腺疾病。其余306名患者中，有96.4％在随访期间进行了至少一项甲状腺检查。当评估这些患者之间的测试时间间隔时，在12个月时甲状腺功能检查要求中有一个离散的峰值，与常规的年度检查一致。大多数请求（77％）源自常规设置。

结论

与目前的指南相反，我们提供了证据，提示定期筛查T2DM患者的甲状腺功能障碍，特别是在一般情况下。这种做法的适当性尚不清楚，但可能需要进一步检查以评估筛查的临床益处，并与费用进行权衡。