When hyperthyroidism is complicated with diabetes, the key to treatment is to effectively control hyperthyroidism as soon as possible while treating diabetes.
When the elevated thyroid hormone level is controlled and the symptoms of hyperthyroidism are relieved, glucose metabolism can also be improved.
There are three conventional treatment methods for hyperthyroidism, mainly drug therapy, radioactive iodine therapy and surgical treatment, but for hyperthyroidism complicated with diabetes, the choice of treatment methods is different.
1. Drug therapy should increase dose and course of treatment,
The selection of antithyroid drugs is basically the same as that of ordinary hyperthyroidism patients, but the dosage of drugs is correspondingly increased compared with that of simple hyperthyroidism patients, and the course of treatment is appropriately prolonged (1 ~ 2 times).
Some studies have reported that the cure rate of drug therapy for Graves disease is only about 30% in clinical practice. Therefore, some experts believe that in view of the serious adverse effects of high thyroid hormone levels on blood sugar control and the risk of deterioration of cardiovascular diseases, radioactive iodine therapy should be selected for radical treatment of hyperthyroidism complicated with diabetes.
2. Radioiodine therapy is recommended.
Radioiodine therapy can quickly and effectively control the symptoms of hyperthyroidism. The treatment process is simple and convenient. Generally, thyroid function can return to normal level after 3-4 months. However, the incidence rate of hypothyroidism in the later period is relatively high. For each different patient, whether the treatment scheme of radioiodine therapy is suitable should be judged by specialists.
Before and after radioactive iodine therapy, it is still necessary to combine drug therapy to control thyroid level so as not to induce hyperthyroidism crisis.
What is a hyperthyroidism crisis? Click on the blue character on the left to view it immediately)
When hypothyroidism occurs in the later period, minor cases only need regular reexamination and do not need special treatment. Serious cases need to take thyroid hormone replacement drugs to supplement the thyroid hormone lacking in the body. As long as the thyroid function is controlled within the normal range, the impact on the body is relatively small.
3. The risk of surgical treatment will increase,
Due to the influence of diabetes, patients with hyperthyroidism complicated with diabetes will lead to easy infection and slow healing of surgical incisions. At the same time, surgery will also increase the risk of inducing hyperthyroidism crisis. In addition to these problems, patients with diabetes are often complicated with cardiovascular and kidney diseases, which increases the risk of surgery by another point.
Therefore, the choice of surgical treatment should be cautious.
However, in some cases, priority has to be given to surgical treatment, For example, patients suspected of thyroid cancer or nodular goiter. If surgical treatment is selected, To control hyperthyroidism symptoms and blood sugar range before surgery, Before the operation, specialists should also evaluate the functions of various systems and organs, and treat the causes of the disease, so as to adjust the body to the best state to meet the requirements of the operation. During the operation, doctors will monitor the blood sugar level and adjust the insulin dosage in time to avoid the symptoms of ketosis coma and hypoglycemia. After the operation, blood sugar should also be detected in time.
4. Other precautions
Propranolol, another common drug in hyperthyroidism patients, can cover up the hypoglycemia symptoms of diabetic patients. Hyperthyroidism patients with diabetes should avoid using it.
When hyperthyroidism and diabetes exist together, it is not difficult to diagnose, but sometimes it is easy to ignore one of the diseases because the other is found, resulting in misdiagnosis and missed diagnosis, thus delaying treatment and even aggravating the disease.
Therefore, when going to the hospital, you must inform the doctor of some uncomfortable symptoms. If you suspect that you may have other diseases at the same time, you can also consult the doctor and ask the doctor for help in the investigation.
At the same time, after the treatment is started, if the effect is not ideal, it is also necessary to review it as soon as possible. On the one hand, it is necessary to confirm whether the treatment has worked, and on the other hand, it is necessary for doctors to check whether it is caused by other diseases.