ABSTRACT:

Diabetes Mellitus (DM) and thyroid dysfunction are the two most common endocrine disorders that occurs together. Thyroid dysfunction occurs in patients with both type 1 and type 2 diabetes mellitus but the association is greater in type 1, probably because of the shared autoimmune predisposition. Worldwide it is reported up to 30% of children with DM have co-existent thyroid autoimmunity with subsequent high prevalence of thyroid dysfunction which has been observed to adversely affect diabetes control and growth impairment to affected children.

This study aimed to determine the prevalence, pattern and associated factors of thyroid dysfunction among children and adolescents with DM attending clinic at three hospitals in Mwanza, Tanzania.

Methods: This was a hospital based cross-sectional study conducted from September 2018 to March 2019. A structured pre tested questionnaire was used to colect socio demographic and clinical information. Blood was collected and tested for thyroid hormones (FT3, FT4, and TSH) by use of ELISA test kits and HBA1C by a DCA 2000 HbA1c reagent kit at BMC main lab. Data were analyzed by use of STATA software version 13.

Results: A total of 146 children and adolescents with diabetes mellitus from three hospitals in Mwanza were recruited, their median age was 16.5 [IQR 13-19] years. The prevalence of thyroid dysfunction was 10.3% (15/146). The significant factors associated with thyroid dysfunction were female sex (OR 5.7; 95% CI 1.2 – 26.1; p=0.026) and duration of diabetes mellitus (OR 1.2; 95% CI 1.1 – 1.4; p=0.022).

Conclusion:Thyroid dysfunction is a prevalent problem in children and adolescents with Diabetes mellitus attending outpatient clinic in three hospitals in Mwanza and is independently associated with female sex and increased duration of diabebtes mellitus.

Recommendation: This results strengthen the argument for screening of thyroid function in adolescents with DM especialy female who are at puberty as recommended by consensus guidelines.