Thyroid Disorders and Diabetes Mellitus: Double Trouble

Thyroid disease and diabetes are known to be pathophysiologically associated. These associations have clinically relevant implications for insulin sensitivity and adequate management requirements. Interconnections of common signalling pathways forms the underlying basis of this association. Unrecognised thyroid dysfunction may impair metabolic control in patients with diabetes. Interactions between thyroid hormone and the basal mechanisms controlling appetite, energy expenditure and insulin sensitivity regulation are also important areas to explore. The pathophysiological mechanisms underlying this linked regulation are increasingly being unravelled. A clearer understanding of this multifaceted relationship between diabetes mellitus and thyroid disease has the potential to assist in optimization of treatment in diabetic patients. However, there is no consensus regarding optimal thyroid screening strategies in routine diabetes care.