To the Editor.—
A variety of drugs and disease states have been associated with abnormalities in serum concentration of thyroxine (T4) to triiodothyronine (T3). Carbohydrate starvation is one condition in which low T3 levels are observed.1 Uncontrolled diabetes may be considered a state of carbohydrate starvation because glucose does not enter cells normally. Thus, one might expect low T3 levels in uncontrolled diabetes.We measured serum T3, T4, and thyroid-stimulating hormone (TSH) levels by radioimmunoassay in 22 poorly controlled diabetic patients (fasting blood glucose levels, 270 to 366 mg/dl). Twenty-four nondiabetics served as controls. The T3 uptakes were also measured, and free T3 and free T4 indexes were calculated to account for changes in the concentration of binding proteins. The mean values (±SD) in the controls vs the diabetics were as follows: free T3 index, 104+15 vs 109±19; free T4
Rosenblatt S, Hershman JM. Thyroid Hormones in Uncontrolled Diabetes Mellitus. JAMA. 1978;240(19):2047. doi:10.1001/jama.1978.03290190025017
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