Prevalence and Clinical Significance of Subclinical Hypothyroidism in Diabetic Peripheral Neuropathy

Background and Objective: The diabetic Mellitus common and spiking complication is Diabetic peripheral neuropathy (DPN). It is frequently associated with thyroid dysfunction. The subclinical hypothyroidism prevalence and clinical outcomes have been investigated by various studies. The present study aims to determine the prevalence of subclinical hypothyroidism in diabetic peripheral neuropathy patients. Methods: This cross-sectional study was carried out on 164 diabetic neuropathy patients attending the medicine department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK during the study period from 2020 to 2021. Patients’ demographic details, clinical history, and neurological examination were recorded. Normal free thyroxin value was set as a referential standard for subclinical hypothyroidism diagnosis among all the patients. Diabetic neuropathy patients’ clinical manifestations were recorded as per neurological screening instrument. The clinical scoring system was utilized for DPN severity categorization into mild (6-8), moderate (9-11), and severe (>12). SPSS version 20 and a logistic regression model were used for data analysis. Results: This study enrolled 164 diabetic peripheral neuropathy patients. Of the total 164, 69 (42.1%) were male and 95 (57.9%) were female. The overall mean age was 49.61±13.72 years. The prevalence of subclinical hypothyroidism was 32 [19.5%; 95% CI; 14.3%-23.7%]. The diabetic peripheral neuropathy patients with subclinical hypothyroidism had a higher prevalence of severity 86 [52.4%; 95%CI] compared to DNP patients without SCH 46 [28.04%; 95% CI] with a 3% level of significance. A higher HbA1c and HOMA-IR was found in patients with their respective values were (8.3±1.1 against 7.2±1.3) where p-value <0.001 and (3.5 ± 0.9 vs. 2.6 ± 0.8, p<0.001) respectively. Conclusion: The diabetic peripheral neuropathy patients are susceptible to have frequent subclinical hypothyroidism independently associated with severity and complications of DPN. Thyroid function should be tested in DM patients and given to DM patients with SCH. Keywords: Diabetes mellitus; Subclinical hypothyroidism; Diabetic peripheral neuropathy