Grave's disease and diabetes

[butterfly197]

I'm asking you about the case of a 44 year old women diagnosed 10 yers ago with Grave's disease under remision in the last years (no treatment) whose simptoms reappeared in the last 4 weeks together with higher glycaemic values (126-220-240 mg/dl fasting). The visit to the diabetologist revealed a glycemic value of 369 mg/dl (7 pm), in the afternoon. She complained of polidypsia, dry mouth, weight loss. Insulinotherapy was initiated with glargine, ten units at bedtime (glycemic value before aministration was 169) after reiceiving 6 units of aspart imediately (7 pm). Next day a fasting value of 140 mg/dl. Bedtime value (2 hours postprandial ) 269. After 10 U glargine, fasting value 120 mg/dl. Glycemic variation are very important and depend on the thyroid status.
What is your opnion? Is this a temporary glycemic instability, type 2 or type 1 diabetes? Anti GAD, C peptide should help us I think...

[Smilerdeb]

Graves Disease is an Autoimmune Disease and usually when one autoimmune disease is found, there is usually a 2nd one found (this one being Diabetes).

The Graves and Hyperthyroidism can be treated by either anti-thyroid meds or pernmanant treatment which will eventually stablaise the Diabetes although this is extremely hard if the Diabetes has been undetected for a long time.

And something to watch for is ...Metformin can interefer with thyroid medications.
So this person has a double whammy if her Hyperthyroidism is not treated properly.
All the while the Graves antibodies are attacking the thyroid, the diabetes will be unstable.
All in all...most Docs want to ablate the thyroid (sending the antibodies from the Graves into a dormant state) and then concentrate on the diabetes.

Also diabetes II can be treated by medication to help the pancreas produce insulin but Diabetes I is a much more serious condition which requires insulin as the pancreas has completely stopped working.

I think an Endo is in order here as with all diabetes II...it can turn into diabetes I if not controlled properly.
Diet can also help the diabetes II with meds and also a low GI diet.