Structural features of the thyroid gland in patients with type 2 diabetes mellitus and comorbid pathology under chronic stress

Purpose: to assess the features of changes in the structure of the thyroid gland (TG) in patients with type 2 diabetes mellitus (DM) in 2024 compared to the period before 2022.

Object and research methods. In the period 2021–2024, a prospective study was conducted, which included patients with type 2 DM and glycated hemoglobin level ≥7%, who had autoimmune thyroiditis, hypothyroidism in a state of medical compensation. Ultrasound examination was performed on 300 patients aged 19–75 years: 148 were examined by 2022, 152 — in 2024.

Results. The size of the TG using ultrasound by 2022 in patients with type 2 DM, the frequency of goiter detection was 42.5%, in 2024 — 54%. Goiter was detected more often in women with type 2 DM. By 2022, the TG volume was increased in 45% of women and 37% of men, in 2024 — in 52% and 44%, respectively. Hypoechoic heterogeneous type of thyroid echostructure was the most typical in patients with autoimmune thyroiditis and type 2 DM, in 2024 the proportion of hypoechoic homogeneous pattern increased (from 9 to 13%). In women with type 2 DM, the «isoechogenic homogeneous» pattern was not observed in 2022 and similarly in 2024. A distinctive feature of the male distribution until 2022 was a higher proportion of isoechoic heterogeneous structure of the thyroid parenchyma than in women (16% vs. 12%). In 2024, compared to the period before 2022, the proportion of isoechoic heterogeneous structure decreased in men, while the proportion of hypoechoic heterogeneous structure increased.

Conclusion. There was a significant increase in the proportion of goiter detection in patients with type 2 DM in 2024 compared to the period before 2022, reflecting the integral impact of chronic stress on the compensation of both diseases.