The public health burden of diabetes mellitus and thyroid disease: twin epidemics
ElSayed, N. A. et al. Classification and diagnosis of diabetes: standards of care in diabetes — 2023. Diabetes Care 46, S19–S40 (2023).
Google Scholar
Sun, H. et al. IDF diabetes atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res. Clin. Pract. 183, 109119 (2022).
Google Scholar
Handelsman, Y. et al. Cardiovascular outcomes in patients with diabetes and kidney disease: JACC review topic of the week. J. Am. Coll. Cardiol. 82, 161–170 (2023).
Google Scholar
Sinha, R. A. & Yen, P. M. Metabolic messengers: thyroid hormones. Nat. Metab. 6, 639–650 (2024).
Google Scholar
Chaker, L. et al. Hypothyroidism. Nat. Rev. Dis. Primers 8, 30 (2022).
Google Scholar
Binder, G. et al. Thyroid disorders in children and adolescents: a review. JAMA Pediatr. 170, 1008–1019 (2016).
Google Scholar
Laurberg, P. et al. Hyperthyroidism: aetiology, pathogenesis, diagnosis, management, complications, and prognosis. Lancet Diabetes Endocrinol. 11, 282–298 (2023).
Google Scholar
Davies, T. F. et al. Graves’ disease. Autoimmune Rev. 22, 102805 (2023).
Smith, T. J. & Hegedüs, L. Graves’ disease. N. Engl. J. Med. 375, 1552–1565 (2016).
Google Scholar
Kahaly, G. J. & Hansen, M. P. Type 1 diabetes associated autoimmunity. Autoimmun. Rev. 15, 644–648 (2016).
Google Scholar
Hadgu, R., Worede, A. & Ambachew, S. Prevalence of thyroid dysfunction and associated factors among adult type 2 diabetes mellitus patients, 2000–2022: a systematic review and meta-analysis. Syst. Rev. 13, 119 (2024).
Google Scholar
Gronich, N. et al. Hypothyroidism is a risk factor for new-onset diabetes mellitus: a population-based cohort study. BMC Med. 19, 257 (2021).
Rong, F. et al. Association between thyroid dysfunction and type 2 diabetes: a meta-analysis of prospective observational studies. BMC Med. 19, 257 (2021).
Google Scholar
Dueñas, O. H. R. et al. Thyroid function and the risk of prediabetes and type 2 diabetes. J. Clin. Endocrinol. Metab. 107, 1789–1798 (2025).
Google Scholar
Biondi, B., Kahaly, G. J. & Robertson, R. P. Thyroid dysfunction and diabetes mellitus: two closely associated disorders. Endocr. Rev. 40, 789–824 (2019).
Google Scholar
Mobasseri, M. et al. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot. Perspect. 10, 98–115 (2020).
Google Scholar
Abela, A. G. & Fava, S. Why is the incidence of type 1 diabetes increasing. Curr. Diabetes Rev. 17, e030521193110 (2021).
Google Scholar
Herczeg, V. et al. Increasing prevalence of thyroid autoimmunity in childhood type 1 diabetes in the pre-COVID but not during the COVID era. Front. Endocrinol. 15, 1496155 (2025).
Google Scholar
Nederstigt, C., Corssmit, E. P. M., de Koning, E. J. P. & Dekkers, O. M. Incidence and prevalence of thyroid dysfunction in type 1 diabetes. J. Diabetes Complications 30, 420–425 (2016).
Google Scholar
Frommer, L. & Kahaly, G. J. Type 1 diabetes and associated autoimmune diseases. World J. Diabetes 11, 527–539 (2020).
Google Scholar
National Institute for Health and Care Excellence. When should I screen for hypothyroidism? NICE (2024).
Garber, J. R. et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr. Pract. 18, 988–1028 (2012).
Google Scholar
Birtwhistle, R. et al. Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care. CMAJ 191, E1274–E1280 (2019).
Google Scholar
Huang, X., Wu, Y., Ni, Y. & He, Y. Global, regional, and national burden of type 2 diabetes mellitus caused by high BMI from 1990 to 2021, and forecast to 2045: analysis from the Global Burden of Disease Study 2021. Front. Public. Health 13, 1515797 (2025).
Google Scholar
Guzman-Vilca, W. C. & Carrillo-Larco, R. M. Number of people with type 2 diabetes mellitus in 2035 and 2050: a modelling study in 188 countries. Curr. Diabetes Rev. 21, e120124225603 (2024).
Google Scholar
Kyrou, I. et al. Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: a narrative review with emphasis on data from Europe. BMC Endocr. Disord. 20, 134 (2020).
Google Scholar
Fleiner, H. F. et al. Prevalence of thyroid dysfunction in autoimmune and type 2 diabetes: the population-based HUNT study in Norway. J. Clin. Endocrinol. Metab. 101, 669–677 (2016).
Google Scholar
Benseñor, I. M. et al. Thyrotropin levels, insulin resistance, and metabolic syndrome: a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Metab. Syndr. Relat. Disord. 13, 362–369 (2015).
Google Scholar
Roos, A. et al. Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J. Clin. Endocrinol. Metab. 92, 491–496 (2007).
Google Scholar
Jun, J. E. et al. Association between changes in thyroid hormones and incident type 2 diabetes: a seven-year longitudinal study. Thyroid 27, 29–38 (2017).
Google Scholar
Alwan, H. et al. Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies. Eur. J. Endocrinol. 187, S35–S46 (2022).
Google Scholar
Pinto, S., Croce, L., Carlier, L., Cosson, E. & Rotondi, M. Thyroid dysfunction during gestation and gestational diabetes mellitus: a complex relationship. J. Endocrinol. Invest. 46, 1737–1759 (2023).
Google Scholar
Pinto, S. et al. Association between hypothyroidism and metabolic profile in gestational diabetes mellitus. Front. Endocrinol. 16, 1614802 (2025).
Google Scholar
Eom, Y. S., Wilson, J. R. & Bernet, V. J. Links between thyroid disorders and glucose homeostasis. Diabetes Metab. J. 46, 239–256 (2022).
Google Scholar
Giannakou, K. et al. Risk factors for gestational diabetes: an umbrella review of meta-analyses of observational studies. PLoS ONE 14, e0215372 (2019).
Google Scholar
Osinga, J. A. J. et al. Association of gestational thyroid function and thyroid autoimmunity with gestational diabetes: a systematic review and individual participant meta-analysis. Lancet Diabetes Endocrinol. 13, 651–661 (2025).
Google Scholar
Zou, C., Shen, Q., Yang, Y., Liao, Y. & Du, Q. Association of maternal thyroid function and gestational diabetes with pregnancy outcomes: a retrospective cohort study. Front. Endocrinol. 16, 1555409 (2025).
Google Scholar
Alexander, E. K. et al. 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid 27, 315–389 (2017).
Google Scholar
[No authors listed] Thyroid disease in pregnancy: ACOG Practice Bulletin, number 223. Obstet. Gynecol. 135, e261–e274 (2020).
Google Scholar
Stagnaro-Green, A., Dong, A. & Stephenson, M. D. Universal screening for thyroid disease during pregnancy should be performed. Best. Pract. Res. Clin. Endocrinol. Metab. 34, 101320 (2020).
Google Scholar
Delgado-Rodríguez, M. & Llorca, J. Bias. J. Epidemiol. Community Health 58, 635–641 (2004).
Google Scholar
Perros, P., McCrimmon, R. J., Shaw, G. & Frier, B. M. Frequency of thyroid dysfunction in diabetic patients: value of annual screening. Diabet. Med. 12, 622–627 (1995).
Google Scholar
Flynn, R. W. et al. The thyroid epidemiology, audit, and research study: thyroid dysfunction in the general population. J. Clin. Endocrinol. Metab. 89, 3879–3884 (2004).
Google Scholar
Pleić, N., Gunjača, I., Babić Leko, M. & Zemunik, T. Thyroid function and metabolic syndrome: a two-sample bidirectional Mendelian randomization study. J. Clin. Endocrinol. Metab. 108, 3190–3200 (2023).
Google Scholar
Jonklaas, J. & Razvi, S. Reference intervals in the diagnosis of thyroid dysfunction: treating patients not numbers. Lancet Diabetes Endocrinol. 7, 473–483 (2019).
Google Scholar
Guan, B. et al. Effect of bariatric surgery on thyroid function in obese patients: a systematic review and meta-analysis. Obes. Surg. 27, 3292–3305 (2017).
Google Scholar
Lips, M. A. et al. Roux-en-Y gastric bypass and calorie restriction induce comparable time-dependent effects on thyroid hormone function tests in obese female subjects. Eur. J. Endocrinol. 169, 339–347 (2013).
Google Scholar
Azran, C. et al. Hypothyroidism and levothyroxine therapy following bariatric surgery: a systematic review, meta-analysis, network meta-analysis, and meta-regression. Surg. Obes. Relat. Dis. 17, 1206–1217 (2021).
Google Scholar
Tee, S. A., Tsatlidis, V. & Razvi, S. The GLP-1 receptor agonist exenatide reduces serum TSH by its effect on body weight in people with type 2 diabetes. Clin. Endocrinol. 99, 401–408 (2023).
Google Scholar
Santini, F. et al. Mechanisms in endocrinology: the crosstalk between thyroid gland and adipose tissue: signal integration in health and disease. Eur. J. Endocrinol. 171, R137–R152 (2014).
Google Scholar
Fontenelle, L. C. et al. Thyroid function in human obesity: underlying mechanisms. Horm. Metab. Res. 48, 787–794 (2016).
Google Scholar
Nannipieri, M. et al. Expression of thyrotropin and thyroid hormone receptors in adipose tissue of patients with morbid obesity and/or type 2 diabetes: effects of weight loss. Int. J. Obes. 33, 1001–1006 (2009).
Google Scholar
Chen, X., Zhang, C., Liu, W., Zhang, J. & Zhou, Z. Laparoscopic sleeve gastrectomy-induced decreases in FT3 and TSH are related to fasting C-peptide in euthyrioid patients with obesity. Diabetes. Metab. Syndr. Obes. 13, 4077–4084 (2020).
Google Scholar
Wang, X. et al. Causal association between serum thyrotropin and obesity: a bidirectional, Mendelian randomization study. J. Clin. Endocrinol. Metab. 106, e4251–e4259 (2021).
Google Scholar
Feller, M. et al. Association of thyroid hormone therapy with quality of life and thyroid-related symptoms in patients with subclinical hypothyroidism: a systematic review and meta-analysis. JAMA 320, 1349–1359 (2018).
Google Scholar
Okosieme, O. et al. Management of primary hypothyroidism: statement by the British Thyroid Association executive committee. Clin. Endocrinol. 84, 799–808 (2016).
Google Scholar
Razvi, S., Korevaar, T. I. M. & Taylor, P. Trends, determinants, and associations of treated hypothyroidism in the United Kingdom, 2005–2014. Thyroid 29, 174–182 (2019).
Google Scholar
Song, F. et al. The prevalence and determinants of hypothyroidism in hospitalized patients with type 2 diabetes mellitus. Endocrine 55, 179–185 (2017).
Google Scholar
McCahon, D., Haque, M. S., Parle, J., Hobbs, F. R. & Roberts, L. M. Subclinical thyroid dysfunction symptoms in older adults: cross-sectional study in UK primary care. Br. J. Gen. Pract. 70, e208–e214 (2020).
Google Scholar
Hollowell, J. G. et al. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J. Clin. Endocrinol. Metab. 87, 489–499 (2002).
Google Scholar
Javaid, U., Kennedy, D., Addison, C., Tsatlidis, V. & Razvi, S. Frequency, determinants and costs of thyroid function testing in a laboratory serving a large population. Eur. J. Endocrinol. 186, 553–560 (2022).
Google Scholar
Surks, M. I. & Hollowell, J. G. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J. Clin. Endocrinol. Metab. 92, 4575–4582 (2007).
Google Scholar
Zhai, X. et al. An age-specific serum thyrotropin reference range for the diagnosis of thyroid diseases in older adults: a cross-sectional survey in China. Thyroid 28, 1571–1579 (2018).
Google Scholar
Lee, S. Y. & Pearce, E. N. Hyperthyroidism: a review. JAMA 330, 1472–1483 (2023).
Google Scholar
Han, C. et al. Subclinical hypothyroidism and type 2 diabetes: a systematic review and meta-analysis. PLoS ONE 10, e0135233 (2015).
Google Scholar
Bano, A. et al. Thyroid function and the risk of fibrosis of the liver, heart, and lung in humans: a systematic review and meta-analysis. Thyroid 30, 806–820 (2020).
Google Scholar
Ding, X. et al. Subclinical hypothyroidism in polycystic ovary syndrome: a systematic review and meta-analysis. Front. Endocrinol. 9, 700 (2018).
Google Scholar
Vyakaranam, S., Vanaparthy, S., Nori, S., Palarapu, S. & Bhongir, A. V. Study of insulin resistance in subclinical hypothyroidism. Int. J. Health Sci. Res. 4, 147–153 (2014).
Google Scholar
Lu, C. & Cheng, S. Y. Thyroid hormone receptors regulate adipogenesis and carcinogenesis via crosstalk signaling with peroxisome proliferator-activated receptors. J. Mol. Endocrinol. 44, 143–154 (2010).
Google Scholar
Moskva, K. A. et al. Effect of pioglitazone on thyroid stimulating hormone and insulin resistance in hypothyroid patients [abstract 976]. Diabetologia 58, 1–607 (2015).
Lupoli, R. et al. Effects of treatment with metformin on TSH levels: a meta-analysis of literature studies. J. Clin. Endocrinol. Metab. 99, E143–E148 (2014).
Google Scholar
Kim, H. J. et al. Thyroid autoimmunity and metabolic syndrome: a nationwide population-based study. Eur. J. Endocrinol. 185, 707–715 (2021).
Google Scholar
Hoffmann, C. J. & Brown, T. T. Thyroid function abnormalities in HIV-infected patients. Clin. Infect. Dis. 45, 488–494 (2007).
Google Scholar
Melamed, S. B. et al. Thyroid function assessment before and after diagnosis of schizophrenia: a community-based study. Psychiatry Res. 293, 113356 (2020).
Google Scholar
Shanbhogue, V. V., Finkelstein, J. S., Bouxsein, M. L. & Yu, E. W. Association between insulin resistance and bone structure in nondiabetic postmenopausal women. J. Clin. Endocrinol. Metab. 101, 3114–3122 (2016).
Google Scholar
Jansen, H. I., Bruinstroop, E., Heijboer, A. C. & Boelen, A. Biomarkers indicating tissue thyroid hormone status: ready to be implemented yet? J. Endocrinol. 253, R21–R45 (2022).
Google Scholar
Birkebaek, N. H. et al. Effect of weight reduction on insulin sensitivity, sex hormone-binding globulin, sex hormones and gonadotrophins in obese children. Eur. J. Endocrinol. 163, 895–900 (2010).
Google Scholar
Krause, C. et al. Reduced expression of thyroid hormone receptor β in human nonalcoholic steatohepatitis. Endocr. Connect. 7, 1448–1456 (2018).
Google Scholar
Harrison, S. A. et al. Resmetirom (MGL-3196) for the treatment of non-alcoholic steatohepatitis: a multicentre, randomised, double-blind, placebo-controlled, phase 2 trial. Lancet 394, 2012–2024 (2019).
Google Scholar
de Candia, P. et al. Type 2 diabetes: how much of an autoimmune disease? Front. Endocrinol. 10, 451 (2019).
Google Scholar
Hawa, M. I. et al. Adult-onset autoimmune diabetes in Europe is prevalent with a broad clinical phenotype: Action LADA 7. Diabetes Care 36, 908–913 (2013).
Google Scholar
Diamanti-Kandarakis, E. et al. Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocr. Rev. 30, 293–342 (2009).
Google Scholar
Gore, A. C. et al. EDC-2: The Endocrine Society’s second scientific statement on endocrine-disrupting chemicals. Endocr. Rev. 36, E1–E150 (2015).
Google Scholar
Howard, S. G. Developmental exposure to endocrine disrupting chemicals and type 1 diabetes mellitus. Front. Endocrinol. 9, 513 (2018).
Google Scholar
Calsolaro, V., Pasqualetti, G., Niccolai, F., Caraccio, N. & Monzani, F. Thyroid disrupting chemicals. Int. J. Mol. Sci. 18, 2583 (2017).
Google Scholar
Hinault, C., Caroli-Bosc, P., Bost, F. & Chevalier, N. Critical overview on endocrine disruptors in diabetes mellitus. Int. J. Mol. Sci. 24, 4537 (2023).
Google Scholar
Martinez-Pinna, J. et al. Endocrine disruptors in plastics alter β-cell physiology and increase the risk of diabetes mellitus. Am. J. Physiol. Endocrinol. Metab. 324, E488–E505 (2023).
Google Scholar
Kohrle, J. & Fradrich, C. Thyroid hormone system disrupting chemicals. Best. Pract. Res. Clin. Endocrinol. Metab. 35, 101562 (2021).
Google Scholar
Goulart-Silva, F., Serrano-Nascimento, C., Texeira, S. S. & Nunes, M. T. Triiodothyronine (T3) induces proinsulin gene expression by activating PI3K: possible roles for GSK-3β and the transcriptional factor PDX-1. Exp. Clin. Endocrinol. Diabetes. 121, 14–19 (2013).
Google Scholar
Ortega, F. J. et al. Subcutaneous fat shows higher thyroid hormone receptor-α1 gene expression than omental fat. Obesity 17, 2134–2141 (2009).
Google Scholar
Wang, C. The relationship between type 2 diabetes mellitus and related thyroid diseases. J. Diabetes Res. 2013, 390534 (2013).
Google Scholar
Weitzel, J. M. & Iwen, K. A. Coordination of mitochondrial biogenesis by thyroid hormone. Mol. Cell Endocrinol. 342, 1–7 (2011).
Google Scholar
Marino, L., Kim, A., Ni, B. & Celi, F. S. Thyroid hormone action and liver disease, a complex interplay. Hepatology 81, 651–669 (2025).
Google Scholar
Videla, L. A. et al. T3-induced liver AMP-activated protein kinase signaling: redox dependency and upregulation of downstream targets. World. J. Gastoenterol. 20, 17416–17425 (2014).
Google Scholar
Falzacappa, C. V. et al. Thyroid hormone receptor TRβ1 mediates Akt activation by T3 in pancreatic β cells. J. Mol. Endocrinol. 38, 221–233 (2007).
Google Scholar
Morte, B. & Bernal, J. Thyroid hormone action: astrocyte-neuron communication. Front. Endocrinol. 5, 82 (2014).
Google Scholar
Chen, G., Xu, S., Renko, K. & Derwahi, M. Metformin inhibits growth of thyroid carcinoma cells, suppresses self-renewal of derived cancer stem cells, and potentiates the effect of chemotherapeutic agents. J. Clin. Endocrinol. Metab. 97, E510–E520 (2012).
Google Scholar
Liu, S. et al. Circulating leptin levels in thyroid dysfunction: a systematic review and meta-analysis. BMC Endocr. Disord. 25, 140 (2025).
Google Scholar
Markos, I. S. et al. The concentration of interleukin 6 and tumor necrosis factor alpha in saliva and blood of patients with inactive multiple sclerosis and coexisting Hashimoto’s thyroiditis. Acta Clin. Croat. 62, 339–344 (2023).
Google Scholar
Tjorve, E., Tjorve, K. M. C., Olsen, J. O., Senum, R. & Oftebro, H. On commonness and rarity of thyroid hormone resistance: a discussion based on mechanisms of reduced sensitivity in peripheral tissues. Med. Hypotheses. 69, 913–921 (2007).
Google Scholar
Lacraustra, M. et al. Impaired sensitivity to thyroid hormones is associated with diabetes and metabolic syndrome. Diabetes Care 42, 303–310 (2019).
Google Scholar
Sun, Y. et al. Impaired sensitivity to thyroid hormones is associated with hyperuricemia, obesity, and cardiovascular disease risk in subjects with subclinical hypothyroidism. Thyroid 32, 376–384 (2022).
Google Scholar
Zhang, C. et al. Effects of acarbose and metformin on thyroid function and thyroid hormone sensitivity in type 2 diabetes patients: a post-hoc analysis of the MARCH study. J. Endocrinol. Invest. 48, 419–433 (2025).
Google Scholar
Sessa, L., Malavolta, E., Sodero, G., Cipolla, C. & Rigante, D. The conspiring role of gut microbiota as primer of autoimmune thyroid diseases: a scoping focus. Autoimm. Rev. 24, 103780 (2025).
Google Scholar
Canfora, E. E., Meex, R. C. R., Venema, K. & Blaak, E. E. Gut microbial metabolites in obesity, NAFLD and T2DM. Nat. Rev. Endocrinol. 15, 261–273 (2019).
Google Scholar
Wu, J., Yang, K., Fan, H., Wei, M. & Xiong, Q. Targeting the gut microbiota and its metabolites for type 2 diabetes mellitus. Front. Endocrinol. 14, 1114424 (2023).
Google Scholar
Jiang, T. et al. Gut microbiota in hypothyroidism: pathogenic mechanisms and opportunities for precision microbiome interventions. Front. Microbiol. 16, 1661211 (2025).
Google Scholar
Shu, Q. et al. Effect of probiotics or prebiotics on thyroid function: a meta-analysis of eight randomized controlled trials. PLoS ONE 19, e0296733 (2024).
Google Scholar
Gray, R. S., Borsey, D. Q., Irvine, W. J., Seth, J. & Clarke, B. F. Natural history of thyroid function in diabetics with impaired thyroid reserve: a four year controlled study. Clin. Endocrinol. 19, 445–451 (1983).
Google Scholar
Wang, J., Gao, J., Fan, Q., Li, H. & Di, Y. The effect of metformin on thyroid-associated serum hormone levels and physiological indexes: a meta-analysis. Curr. Pharm. Des. 25, 3257–3265 (2019).
Google Scholar
Sencar, M. E. et al. The effect of exenatide on thyroid-stimulating hormone and thyroid volume. Eur. Thyroid. J. 8, 307–311 (2019).
Google Scholar
Köseoğlu, D., Özdemir Başer, Ö, Berker, D. & Güler, S. Exenatide treatment reduces thyroid gland volume, but has no effect on the size of thyroid nodules. Acta Endocrinol. 16, 275–279 (2020).
Ye, J., Xu, J., Wen, W. & Huang, B. Effect of liraglutide on serum TSH levels in patients with NAFLD and its underlying mechanisms. Int. J. Clin. Pract. 2022, 1786559 (2022).
Google Scholar
Hitsuwari, T. et al. Two cases of thyrotoxicosis and euglycemic diabetic ketoacidosis under sodium-glucose transport protein 2 inhibitor treatment. Intern. Med. 61, 3069–3075 (2022).
Google Scholar
Nikkila, E. A. & Teir, H. Effects of long-term use of antidiabetic sulfonylureas on thyroid weight and arteriosclerosis. Ann. Med. Exp. Biol. Fenn. 38, 182–185 (1960).
Google Scholar
Lee, S., Tsirbas, A., Goldberg, R. A. & McCann, J. D. Thiazolidinedione induced thyroid associated orbitopathy. BMC Ophthalmol. 7, 8 (2007).
Google Scholar
Brent, G. A. Mechanisms of thyroid hormone action. J. Clin. Invest. 122, 3035–3043 (2012).
Google Scholar
Klieverik, L. P. et al. Effects of thyrotoxicosis and selective hepatic autonomic denervation on hepatic glucose metabolism in rats. Am. J. Physiol. Endocrinol. Metab. 294, E513–E520 (2008).
Google Scholar
Randin, J. P., Tappy, L., Scazziga, B., Jequier, E. & Felber, J. P. Insulin sensitivity and exogenous insulin clearance in Graves’ disease. Measurement by the glucose clamp technique and continuous indirect calorimetry. Diabetes 35, 178–181 (1986).
Google Scholar
Foss, M. C. et al. Peripheral glucose metabolism in human hyperthyroidism. J. Clin. Endocrinol. Metab. 70, 1167–1172 (1990).
Google Scholar
Havekes, B. & Sauerwein, H. P. Adipocyte-myocyte crosstalk in skeletal muscle insulin resistance; is there a role for thyroid hormone. Curr. Opin. Clin. Nutr. Metab. Care 13, 641–646 (2010).
Google Scholar
Cooper, D. S. Antithyroid drugs. N. Engl. J. Med. 352, 905–917 (2005).
Google Scholar
Bartalena, L. Diagnosis and management of Graves’ disease: a global overview. Nat. Rev. Endocrinol. 9, 724–734 (2013).
Google Scholar
Tan, L. et al. NOACs versus warfarin in people with atrial fibrillation and thyroid dysfunction. Medicine 104, e43328 (2025).
Google Scholar
Jonklaas, J. et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on thyroid hormone replacement. Thyroid 24, 1670–1751 (2014).
Google Scholar
Dimitriadis, G. et al. Insulin action in adipose tissue and muscle in hypothyroidism. J. Clin. Endocrinol. Metab. 91, 4930–4937 (2006).
Google Scholar
Mohn, A., Di Michele, S., Di Luzio, R., Tumini, S. & Chiarelli, F. The effect of subclinical hypothyroidism on metabolic control in children and adolescents with type 1 diabetes mellitus. Diabet. Med. 19, 70–73 (2002).
Google Scholar
Ostadrahimi, A. et al. Effects of levothyroxine replacement therapy on insulin resistance in patients with untreated primary hypothyroidism. BMC Res. Notes 16, 237 (2023).
Google Scholar
Cooper, D. S. & Biondi, B. Subclinical thyroid disease. Lancet 379, 1142–1154 (2012).
Google Scholar
Rodondi, N. et al. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA 304, 1365–1374 (2010).
Google Scholar
Collet, T. H. et al. Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Arch. Intern. Med. 172, 799–809 (2012).
Google Scholar
Pearce, S. H. et al. 2013 ETA guideline: management of subclinical hypothyroidism. Eur. Thyroid. J. 2, 215–228 (2013).
Google Scholar
Biondi, B. et al. The 2015 European Thyroid Association guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism. Eur. Thyroid. J. 4, 149–163 (2015).
Google Scholar
Zijlstra, L. E. et al. Levothyroxine treatment and cardiovascular outcomes in older people with subclinical hypothyroidism: pooled individual results of two randomised controlled trials. Front. Endocrinol. 12, 674841 (2021).
Google Scholar
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