methimazole and Diabetes-Mellitus

Drug therapy for the endocrine system is implemented to replace a hormone deficiency or to prevent or reduce the formation or effects of excess hormone. Treatment of endocrine disorders covers diseases of the pituitary, adrenal, parathyroid, and thyroid glands as well as the endocrine pancreas. This article focuses on new therapies currently available for specific diseases. Administration of trilostane for treatment of hyperadrenocorticism and use of insulin glargine, protamine zinc insulin (PZI), and porcine Lente insulin for diabetes mellitus are discussed. In addition, transdermal methimazole therapy for treatment of feline hyperthyroidism and administration of progestins for pituitary dwarfism are considered.

Topics: Adrenocortical Hyperfunction; Animals; Antithyroid Agents; Cat Diseases; Cats; Diabetes Mellitus; Dihydrotestosterone; Dog Diseases; Dogs; Enzyme Inhibitors; Hyperthyroidism; Hypoglycemic Agents; Insulin, Long-Acting; Methimazole

Hypoglycemia is an emergent condition with many causes, including underlying diabetes mellitus either with the use of insulin or oral anti-diabetic medications for glucose control, and organ (heart, hepatic, or renal) failure. Insulin autoimmune syndrome (IAS) can also cause hypoglycemia, however it is relatively difficult to diagnose as it is rare clinically. Although uncommon, IAS can be life threatening in patients with persistent hypoglycemia.. We report the case of a 27-year-old female with underlying Graves' disease who was treated with methimazole (MTZ). After 6 weeks of treatment, she developed hypoglycemia symptoms accompanied by dizziness and cold sweating. We excluded underlying diabetes mellitus, the use of insulin or oral anti-diabetic medications, and organ failure.. Laboratory data showed elevated insulin and C-peptide levels. Therefore, insulinoma and IAS were suspected. Abdominal computed tomography and magnetic resonance imaging ruled out insulinoma, and MTZ-induced IAS was finally diagnosed.. The hypoglycemia symptoms resolved after MTZ was switched to propylthiouracil, confirming the diagnosis of IAS.. This case emphasizes the significance of life-threatening MTZ-induced IAS. IAS should be suspected in patients who develop spontaneous hypoglycemia, especially in those with underlying Graves' disease receiving MTZ who present with hyperinsulinism.

Topics: Adult; Autoimmune Diseases; Diabetes Mellitus; Female; Graves Disease; Humans; Hyperinsulinism; Hypoglycemia; Insulin; Insulinoma; Methimazole; Pancreatic Neoplasms

Topics: Aged; Aged, 80 and over; Antithyroid Agents; Cardiovascular Diseases; Case-Control Studies; Cross-Over Studies; Diabetes Mellitus; Female; Gallstones; Graves Disease; Humans; Liver Diseases, Alcoholic; Male; Methimazole; Middle Aged; Pancreatitis; Prognosis; Risk Factors

Diabetes and hypothyroidism produce adverse effects on body weight and sexual maturity by inhibiting body growth and metabolism. The occurrence of diabetes is always accompanied with thyroid dysfunction. Thus, it is important to take hypo- or hyper-thyroidism into consideration when exploring the adverse effects caused by diabetes. Previous reports have found hypothyroidism inhibits testicular growth by delaying Sertoli cell differentiation and proliferation. Hence, by establishing a mouse model of diabetes combined with hypothyroidism, we provided evidence that poly glandular autoimmune syndrome affected testicular development and spermatogenesis.. we mimicked polyglandular deficiency syndrome in both immature and prepubertal mice by induction of diabetes and hypothyroidism, which caused decreases in serum concentrations of testosterone and insulin like growth factor 1 (IGF-1). Such reduction of growth factor resulted in inhibition of testicular and epididymal development. Moreover, expressions of Claudin-11 were observed between Sertoli cells and disrupted in the testes of syndrome group mice. We also found reduced sperm count and motility in prepubertal mice.. This mimicry of the diabetes and thyroid dysfunction, will be helpful to better understand the reasons for male infertility in diabetic-cum-hypothyroid patients.

Topics: Animals; Blood Glucose; Blood-Testis Barrier; Body Weight; Claudins; Diabetes Mellitus; Epididymis; Female; Hypothyroidism; Insulin-Like Growth Factor I; Male; Methimazole; Mice, Inbred ICR; Organ Size; Seminiferous Tubules; Sperm Motility; Spermatogenesis; Streptozocin; Testosterone

Topics: Alcohols; Chromosome Aberrations; Diabetes Mellitus; Environmental Exposure; Esophageal Atresia; Female; Genetic Predisposition to Disease; Herbicides; Humans; Insecticides; Maternal Age; Meta-Analysis as Topic; Methimazole; Obesity; Parity; Paternal Age; Pregnancy; Prenatal Exposure Delayed Effects; Risk Factors; Smoking; Socioeconomic Factors; White People

Topics: Animals; Antithyroid Agents; Chinchilla; Diabetes Complications; Diabetes Mellitus; Diagnosis, Differential; Female; Glipizide; Hyperthyroidism; Hypoglycemic Agents; Methimazole; Rodent Diseases; Switzerland

Some patients with the insulin autoimmune syndrome have circulating insulin that is heterogeneous. We used reverse phase high performance liquid chromatographic analysis to identify the forms of plasma insulin in patients with this syndrome and compared the results with those in patients with insulin-treated diabetes and patients with hyperinsulinism. Under acidic conditions, free insulin dissociated from insulin antibodies eluted from Bio-Gel P-30 columns as a single peak. When such insulin fractions were applied to reverse phase high performance liquid chromatography, a major insulin peak emerged with the same retention time as standard human insulin in all six patients with the syndrome. In addition, a minor insulin peak was consistently found at relatively high acetonitrile concentrations. However, this hydrophobic insulin also was found in two of four insulin-treated diabetic patients and in one of two hyperinsulinemic patients who did not have insulin antibodies. Preliminary characterization of the variant insulin revealed that it has a molecular size between those of proinsulin and insulin and retains the immunoreactivity of insulin, but not C-peptide. It may be an aggregate of insulin molecule or proinsulin intermediates. Since the variant insulin was not found only in patients with the insulin autoimmune syndrome, it seems unlikely that an altered endogenously produced insulin induces the generation of autoantibodies to insulin in this syndrome.

Topics: Adult; Aged; Autoimmune Diseases; Chromatography, High Pressure Liquid; Diabetes Mellitus; Female; Humans; Hyperinsulinism; Insulin; Male; Methimazole; Middle Aged; Molecular Weight; Proinsulin