Treatment of Hyperthyroidism in Type 1 Diabetes

Diagnosis and Screening

• Patients with type 1 diabetes should be screened for thyroid autoantibodies at the time of diabetes diagnosis due to the high prevalence of autoimmune thyroid disease in this population, with thyroid-stimulating hormone (TSH) measured after metabolic control has been established, and if normal, rechecked every 1-2 years or sooner if symptoms of thyroid dysfunction develop, as recommended by the American Diabetes Association 1, 2
• Hyperthyroidism occurs in approximately 0.5% of patients with type 1 diabetes and can significantly impact diabetes management, according to the American Diabetes Association 1

Treatment Algorithm

Step 2: Insulin Adjustment During Treatment

• Consider sensor-augmented insulin pump therapy with threshold-suspend feature for patients experiencing nocturnal hypoglycemia during the transition period of hyperthyroidism treatment, as suggested by the American Diabetes Association 3, 4

Monitoring and Follow-up

• Continue screening for other autoimmune conditions common in type 1 diabetes, such as celiac disease, as recommended by the American Diabetes Association 1
• Maintain optimal glycemic control using multiple daily insulin injections or continuous subcutaneous insulin infusion, as recommended by the American College of Physicians 5, 6