THYROID ULTRASOUND AND URINARY IODIDE EXC RETION IN CHILDREN AND ADOLESCENTS WITH DIABETES-MELLITUS (IDDM)

Background Date, studies on thyroid volume and urinary iodide excretio n in patients with diabetes mellitus are not available. Sonographicall y determined parameters of the thyroid size are correlated to other an thropometrous data and the urinary iodide excretion is correlated to g lucosuria, the HbA1c value and the diabetes duration. Method In this p rospective study we evaluated sonographically the thyroid volume in 10 7 patients with type I diabetes mellitus and 112 healthy children. The urinary iodide excretion was measured photometrically by using a modi fied eerie ion arsenious acid method for spontaneous urinary specimen and if available for the 24 h collected urin. Results The thyroid volu me depended on site and age. A positive correlation of the thyroid vol ume and age, body weight and height, could be demonstrated. Referring to reference data a goitre prevalence of 30% in juvenile patients with diabetes mellitus type I was detected. Interestingly, juvenile type I diabetics presented with an average urinary iodide excretion of 183,0 mu g iodide/g creatinine. Even the urinary iodide excretion of 162,5 mu g iodide confirmed this increased level. The urinary iodide excreti on in 24 hours correlated with glucosuria and the HbA1c level. The hea lthy children presented with an average urinary iodide excretion of 42 ,6 mu g iodide/g creatinine. The mean value was clearly below the WHO recommendation of 150-300 mu g iodide/g creatinine. Only 2,8% of the h ealthy children examined exceeded the lower limit of this range.Conclu sion In addition to the existing distinct under supply of iodide we as sume an increased urinary iodide excretion in context with the osmotic diuresis in juvenile diabetics. Contrary to current opinion, that the se data are correlated to the daily intake of iodide, which was calcul ated from urinary excretion rate, this thesis could not be affirmed fo r juvenile diabetics. Therefore it seems reasonable to frequently cont rol thyroid volume and thyroid function in children and adolescents wi th diabetes mellitus.