{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:40:31Z","timestamp":1787017231389,"version":"build-2736575974"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"886","license":[{"start":{"date-parts":[[1999,8,1]],"date-time":"1999-08-01T00:00:00Z","timestamp":933465600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,8,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>In a clinic population of 509 type 1 diabetic patients aged 16\u201345 years, 5.5% had received treatment for thyroid disorders (20 hypothyroid, three males; eight thyrotoxicosis, four males), and Addison's disease was present in four patients (0.8%, one male). In all patients, type 1 diabetes preceded the diagnosis of the other autoimmune disorder. The clinical presentation of hypothyroidism was usually insidious with few symptoms, although an increased frequency of hypoglycaemic symptoms and\/or raised serum cholesterol levels often prompted thyroid function testing. In contrast, the patients with thyrotoxicosis had florid symptoms, weight loss (mean 8.12 kg), palpable goitres, increasing insulin requirements, and low cholesterol levels. Six patients did not achieve remission or had recurrent thyrotoxicosis after oral antithyroid treatment and required131I or thyroid surgery. A family history of autoimmune disease was present in 25% of patients with thyroid disorders (seven thyrotoxic and one hypothyroid) and in three of the four patients with Addison's disease. In this population of young adult type 1 diabetic patients, appropriate tests for thyroid dysfunction and Addison's disease should be carried out if there is clinical suspicion and\/or unexplained changes in diabetic metabolic control or serum cholesterol. Careful follow-up of patients with a family history of these conditions is recommended.<\/jats:p>","DOI":"10.1136\/pgmj.75.886.467","type":"journal-article","created":{"date-parts":[[2015,2,17]],"date-time":"2015-02-17T19:04:10Z","timestamp":1424199850000},"page":"467-470","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Clinical presentation of thyroid dysfunction and Addison's disease in young adults with type 1 diabetes"],"prefix":"10.1093","volume":"75","author":[{"given":"King Sun","family":"Leong","sequence":"first","affiliation":[{"name":"University Clinical Departments at Aintree, University Hospital Aintree , Lower Lane, Liverpool L9 7AL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Wallymahmed","sequence":"additional","affiliation":[{"name":"University Clinical Departments at Aintree, University Hospital Aintree , Lower Lane, Liverpool L9 7AL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Wilding","sequence":"additional","affiliation":[{"name":"University Clinical Departments at Aintree, University Hospital Aintree , Lower Lane, Liverpool L9 7AL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"MacFarlane","sequence":"additional","affiliation":[{"name":"University Clinical Departments at Aintree, University Hospital Aintree , Lower Lane, Liverpool L9 7AL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1999,8,1]]},"reference":[{"key":"2023042617063206500_B1","first-page":"64.1","volume-title":"Textbook of diabetes","author":"MacFarlane","year":"1997","edition":"2nd edn."},{"key":"2023042617063206500_B2","first-page":"362","article-title":"Thyroid disorders in children and adolescents with insulin dependent diabetes mellitus","volume":"53","author":"Gruneiro De Papendieck","year":"1995","journal-title":"Acta Pediatr Esp"},{"key":"2023042617063206500_B3","first-page":"101","article-title":"Frequency of autoimmune thyroid disease in adult patients with insulin dependent diabetes mellitus","volume":"14","author":"Gamba","year":"1994","journal-title":"Giornale Ital Diabetol"},{"key":"2023042617063206500_B4","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/j.1464-5491.1995.tb00553.x","article-title":"Frequency of thyroid dysfunction in diabetic patients: Value of annual screening","volume":"12","author":"Perros","year":"1995","journal-title":"Diabet Med"},{"key":"2023042617063206500_B5","doi-asserted-by":"crossref","first-page":"801","DOI":"10.2337\/diacare.13.7.801","article-title":"Screening for thyroid disease in children with IDDM","volume":"13","author":"McKenna","year":"1990","journal-title":"Diabetes 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disease in a community: the Whickham Study","volume":"7","author":"Tunbridge","year":"1977","journal-title":"Clin Endocrinol"},{"key":"2023042617063206500_B10","first-page":"1603","volume-title":"Weatherall DJ, Ledingham JGG, Warrell DA, eds, Oxford textbook of medicine","author":"McGregor","year":"1996","edition":"3rd edn."},{"key":"2023042617063206500_B11","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/S0140-6736(71)91212-8","article-title":"Diabetes mellitus, autoimmunity and ageing","volume":"1","author":"Whittingham","year":"1971","journal-title":"Lancet"},{"key":"2023042617063206500_B12","first-page":"385","volume-title":"Childhood and adolescent diabetes","author":"MacCuish","year":"1994"},{"key":"2023042617063206500_B13","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/S0022-3476(81)80316-2","article-title":"Thyroid autoimmunity in insulin-dependent diabetes mellitus: the case for routine screening","volume":"98","author":"Riley","year":"1981","journal-title":"J Pediatr"},{"key":"2023042617063206500_B14","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1111\/j.1365-2265.1994.tb02790.x","article-title":"Eighty-six cases of Addison's disease","volume":"41","author":"Kong","year":"1994","journal-title":"Clin Endocrinol"},{"key":"2023042617063206500_B15","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/S0022-3476(80)80472-0","article-title":"Adrenal autoantibodies and Addison disease in insulin dependent diabetes mellitus","volume":"97","author":"Riley","year":"1980","journal-title":"J Pediatrics"},{"key":"2023042617063206500_B16","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/BF00262215","article-title":"Clinical and subclinical organ specific autoimmune manifestations in type 1 (insulin dependent) diabetic patients and their first degree 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