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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pituitary-thyroid axis was investigated in nineteen euthyroid patients with severe diabetic ketoacidosis. A 'low T3 syndrome' was found, with the following characteristics: lowered serum concentrations of triiodothyronine (T3), increased reverse triiodothyronine (rT3), slightly low thyroxine (T4), normal thyrotrophin (TSH), slightly increased triiodothyronine uptake (RT3U) values, and a blunted TSH response to thyrotrophin-releasing hormone (TRH). These disturbances in thyroid-function tests required several days good control of the diabetes to be corrected, at least partially. The data suggest the presence of an abnormal extrathyroidal T4 metabolism as well as a pituitary defect. Caution is recommended in the interpretation of thyroid-function tests during and several days after the treatment of diabetic ketoacidosis.
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PMID:A low T3 syndrome in diabetic ketoacidosis. 9 34

The thyrotropic reserves in 13 diabetics without clinical evidence of vasculopathy have been studied and compared with 11 normal subjects. TSH basal levels were found to be lowered when compared with normal ones. When their pituitary gland had been stimulated with synthetic TRH, it was observed that they had a greater response. It is assumed that the diabetics may have some kind of hypothalamic disturbance that might be responsible for the low basal levels of TSH. This, in some way, would create greater sensibility of the thyrotrops. Some borderline hypothyroidism may exist in adult-onset diabetes.
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PMID:Study of thyrotropic reserve in diabetics of adult type. 9 42

The combination of the TRH stimulation of TSH release with the plasma iodide (PII) increase test, which gives a physiological measure of TSH basal activity, allows characterization of a syndrome we have called a low pituitary TSH reserve. These patients were euthyroid, had a normal PII increase test but a mild or no response to TRH. It was chiefly found in acromegaly and diabetes mellitus, after prolonged high levels of thyroid hormones or hypophysectomy. It appears to be a transient state between normal and abnormal thyrotropin function. So the absence of TSH increase after TRH injection can be of diagnostic value only when other tests of thyrotropin function are performed.
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PMID:[Low thyrotrope hormone: a new entity]. 18 93

The authors report a case of Steinert's disease in a woman and discuss the endocrine profile of this disease after giving an account of the criteria of diagnosis. Disorders of gonad function are mild in women, primary testicular atrophy is very frequent in man with reduction in 17-ketosteroids and testosterone. Thyroid function was normal but, in a few cases, a low fixation curve was found (our case) corrected by TSH stimulation. The frequency of cataract emphasizes the interest of this sign for detection. Diabetes, associated with hyperinsulinism, seemed more frequent than in a population without Steinert's disease. The pathogenesis of these endocrine disorders appears secondary and is ill explained if one considers it as a single disease. Better knowledge, no doubt linked to progress in biochemistry of normal and myopathic muscle, will help to explain the pathogenesis.
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PMID:[Endocrine aspects of Steinert's disease]. 18 36

Specific neuroendocrine regulatory mechanisms in rats and mice are known to be involved in the development of pituitary tumours (prolactinomas) in systemic tolerance and carcinogenicity studies of oestrogens, certain progestagens and their combinations. However, the susceptibility of the strain used seems to be of decisive importance. High doses of oestrogens may also, in special cases, stimulate development of PRL cell hyperplasia and tumours in humans. In other species such as the hamster long-term treatment with oestrogens results in hyperplastic and neoplastic changes in MSH-producing cells of the pars intermedia of the pituitary gland. On the other hand, in the dog and monkey, steroid-related pituitary tumours were not observed, in spite of long-term treatment with high doses of oestrogens, progestagens and their combinations. The capability of certain progestagens to stimulate canine GH secretion seems to play a major role as mediator of the species-specific progestagen-induced changes (mammary tumours, diabetes- and acromegalic-like syndrome) in the beagle dog. These progestagens also seem to have, in addition to their antigonadotrophic properties, an inhibitory effect on CRH-ACTH and TRH-TSH activity in the beagle bitch. These effects can be demonstrated in both the hypothalamic-pituitary system and in the corresponding peripheral target organs. These findings in the dog were not comparable to the situation in other species including man. The extent to which all these results in different species are applicable to other species depends on whether their neuroendocrine control systems are qualitatively and/or quantitatively similar. The physiological significance of the different pituitary hormones, sensitivity of target organs as well as a certain genetic disposition in the different species should also be considered. All these factors can vary from species to species. From these facts, it can be easily appreciated that results of experiments on different species with a substance possessing the same quality of biological effect in these species (e.g., oestrogen, progestagen, etc.) can only be compared when the experimental procedure takes account of the effect of this substance on the neuroendocrine system of the different species, and when dosage, mode of administration and period of treatment are correspondingly matched to the physiological conditions of each species.
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PMID:Evaluation of effects of sexual steroids on the hypothalamic-pituitary system of animals and man. 38 May 19

Hypothyroidism in patients with diabetes mellitus is usually primary though rarely secondary hypothyroidism has occurred. An 11 6/12 year old white female developed diabetes mellitus at 8 6/12 years of age. She received treatment up to 40 units NPH daily with adequate control and normal growth. Hypothyroidism was diagnosed after a 3 month history of lethargy, constipation, dryness of skin and decreasing insulin requirement to 10 units NPH per day. Physical examination was entirely normal, except for dry skin. Serum levels of free thyroxine, thyroxine, T3 resin uptake, were low as was 131I uptake. Primary hypothyroidism was ruled out by the absence of goitre, absent antithyroid antibodies, low basal TSH levels and increased 131I uptake after TSH administration. Serum TSH levels rose 4-fold in respone to intravenous TRH administration. The patient was treated with 0.15 mg daily of L-thyroxine with very good response. This report describes a patient with juvenile diabetes mellitus and isolated TSH deficiency with hypothyroidism of probably hypothalamic origin, an association not previously described in children.
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PMID:Isolated thyrotrophin deficiency in diabetes mellitus. 57 89

A 25-year-old woman with severe diabetes mellitus since the age of 7 developed anterior pituitary insufficiency after pregnancy toxaemia with hypofunction of the thyroid, ovaries and adrenal cortex. Following the development of Sheehan's syndrome, her insulin requirment decreased dramatically. I.v. administration of TRH, LRH and vasopressin induced nearly normal pituitary response levels of TSH, LH and plasma cortisol, indicating a hypothalamic damage as the primary aetiological factor.
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PMID:Sheehan's syndrome of hypothalamic origin in a woman with juvenile diabetes mellitus. 93 82

We report on a 5-year-old child who survived an intracerebral crisis, following ketoacidosis-revealing diabetes (DKA), with visual impairment due to a vascular occipital lesion. Two and 4 months after the initial episode, a unique hypothalamopituitary disorder consisting in GH, ACTH, TSH deficiencies and central precocious puberty, was detected. Cranial magnetic resonance images showed no visible lesion in the hypothalamopituitary region. The most likely hypothesis is the ischemia of hypothalamopituitary and occipital regions following possible cerebral edema after hyperhydration. She survived with low visual acuteness and received a combined replacement therapy for the neuroendocrinological deficiencies. This case emphasizes that the rehydration at the initial period of DKA is critical, especially when risk factors for cerebral edema are present (young age, marked hyponatremia). The neuroendocrinological consequences of acute cerebral edema are rare, but physicians must be attentive in survivors of these accidents.
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PMID:Hypothalamopituitary deficiency and precocious puberty following hyperhydration in diabetic ketoacidosis. 132 5

The present study was undertaken to test the effect of food restriction, fasting, and diabetes on the relationship between thyroid hormone receptor occupancy and two biological end points, GH production and the inhibition of TSH secretion, in thyroidectomized rats. The estimated maximal binding capacity (MBC) in diabetic (D) and fasting (F) rats and in animals limited to 25% (FR25) of the food consumption of normal (C) rats was decreased to 57%, 73%, and 76%, respectively, of C values (P < 0.01-0.001), whereas normal values were found in thyroidectomized (Tx) rats and in animals limited to 50% (FR50) of the food intake of C animals. The nuclear T3 content and T3 receptor occupancy were reduced, respectively, to 25% and 29% in Tx, 77% and 81% in FR50, 52% and 69% in FR25, 49% and 66% in F, and 36% and 64% in D rats of the corresponding C values (P < 0.05-0.001). Pituitaries from Tx, FR50, FR25, F, and D rats contained less GH than C pituitaries (0.14%, 81%, 69%, 88%, and 51%, respectively, of C pituitaries; P < 0.05-0.001). Plasma TSH was lower in FR50, FR25, F, and D rats than in C animals (78%, 57%, 52%, and 48%, respectively (P < 0.01-0.001)), and markedly increased in Tx animals. Administration of a single dose of 2, 5, or 10 micrograms T3/100 g BW to Tx C, Tx FR50, TX FR25, Tx F, and Tx D rats resulted in a similar and progressive increase in nuclear T3 in all groups, except for lower values in Tx D animals. However, receptor occupancy did not differ among the different groups at each T3 dose. This treatment resulted in a progressive increase in pituitary GH in all groups; however, in Tx FR50, Tx FR25, Tx F, and Tx D pituitaries, the GH responses to 10 micrograms T3 were only 77%, 59%, 44%, and 27%, respectively, of that in Tx C rats. (P < 0.05-0.001). Moreover, significant differences in the GH response to 10 micrograms T3 were observed among Tx FR50, Tx FR25, Tx F, and Tx D animals (P < 0.01-0.001). In addition plasma TSH levels in untreated Tx FR50, Tx FR25, Tx F, and Tx D rats were only 88%, 82%, 79%, and 72%, respectively, of that in Tx C animals (P < 0.05-0.01).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Effect of restricted feeding, fasting, and diabetes on the relationship between thyroid hormone receptor occupancy, growth hormone induction, and inhibition of thyrotropin release in thyroidectomized rats. 139 6

Spuriously high value of serum free triiodothyronine (FT3: Amerlex free T3 kit, Amersham, UK.) was noted accidentally on routine laboratory examination of two clinically euthyroid patients (case 1: FT3; 18.5 pg/ml, FT4; 1.1 ng/dl, T3; 103 ng/dl, T4; 8.2 micrograms/dl, TSH; 1.74 microU/ml, case 2: FT3; 8.5 pg/ml, FT4; 1.1 ng/dl, T3; 137 ng/dl, T4; 8.9 micrograms/dl, TSH; 1.45 microU/ml), the former with poorly controlled diabetes (FBG 253 mg/dl, HbA1c 12.1%) and the latter with essential hypertension (184/108 mmHg). Although the hypertensive patient showed mild diffuse goiter, there was no evidence that the patients had autoimmune thyroid diseases because anti-thyroglobulin antibody tests measured by radioimmunoassay and MCHA, TGHA or TBII were all negative. Their serum levels of TBG were within the normal range. Further studies revealed that both patients' sera had unusual binding activity to labelled polyaminocarboxy T3 (125I-aT3) but not labelled T3 (125I-T3). Furthermore, this binding protein was precipitated by goat anti-human immunoglobulin G (IgG). The IgG purified from both patients' sera also showed strong binding activity to 125I-aT3, which was inhibited by unlabelled T3 in a dose dependent manner. In conclusion, we found anti-T3 antibody in two clinically euthyroid patients with no apparent evidence of complicating autoimmune thyroid diseases. The stronger binding activity to polyaminocarboxy T3 rather than T3 may lead to the spuriously high value of serum FT3. The mechanisms of the production of such autoantibodies in our cases should be further investigated.
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PMID:[Studies on thyroid hormone autoantibody in two euthyroid cases with spuriously high value of serum free triiodothyronine]. 146 96


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