Dr Raghunandan Meena, Dr Subhita Choudhary, Dr Khushala Ram Choudhary


Introduction: HbA1c is an important parameter in diagnosis of diabetes. However, Glycated hemoglobin (HbA1c) may
not accurately reflect the level of glycemia in conditions of altered erythrocyte turnover.
Objective: to determine HbA1c levels in non-diabetic patients with newly detected hypothyroidism and to determine
the effect of thyroid hormone replacement therapy on HbA1c levels.
Material and method: A prospective study was carried out July 2019 to December 2019 in the Department of Medicine
in a tertiary care teaching institute in Jhalawar, District, Rajasthan. Total 128 Patients with newly detected hypothyroidism
were included in this study. Thyroid hormone replacement was prescribed for 3 months to all patients.Paired t-test (2-
tailed) was used to compare means of different parameters before and after the restoration of euthyroid state.
Results: Thyroid replacement therapy showed a statistically significant difference in haemoglobin level (p=0.008),
thyroid profile (p=0.001) and HbA1c level (p=0.007) of study participants. There was a significant negative correlation
between glycosylated haemoglobin and serum T4 levels (r =-0.42, p <0.05). Serum TSH level shows significantly positive
correlation with glycosylated haemoglobin (r = 0.26, p <0.05).
Conclusion: The study revealed a statistically significant reduction in mean HbA1c after thyroid replacement therapy
which concludes that correction of hypothyroid states was associated with fall in HbA1c levels. A significantly positive
correlation was found between Serum TSH level and glycosylated hemoglobin. It implies that that thyroid hormone
affects HbA1c values.


Thyroid hormone, Hypothyroidism, HbA1c, TSH.

Full Text:



International Diabetes Federation. IDF Diabetes Atlas Update Poster. 6th ed. Brussels, Belgium: International Diabetes Federation; 2014.

Gupta V.Diabetes in Elderly patients.JK practitioner,2002:49:631-642.

Singh G, Gupta V, Sharma AK, Gupta N. Evaluation of Thyroid Dysfunction Among type 2 diabetic Punjabi population. Advances in Bioresearch. 2011; 2(2): 3-9.

Sathish R and Mohan V. Diabetes and thyroid Disease. Int J DiabDev Countries. 2003; 23: 120-123

Granner DK. Thyroid hormones. In: Murray RK, Granner DK, Mayes PA, Rodwell VW, editors. Harper’s Biochemistry. 25th ed. London: Prentice-Hall International Inc.; 2000. p. 533–8.

Johnson JL. Diabetes control in thyroid disease. Diabetes Spectr. 2006;19:148–53.

Zachary T,Bloomgarden. Cardiovascular Disease, Neuropathy and Retinopathy.Diabetes care 2009;32: e64- e 68.

The International Expert Committee. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes Care. 2009;32(7):1327-34.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(Suppl 1):S62-9.

International expert committee report on the role of the A1c assay in the diagnosis of diabetes. Diabetes Care. 2009; 32:1-8.

Bunn HF, Haney DN, Kamin S, Gabbay KH, Gallop PM. The biosynthesis of human hemoglobin A1c. Slow glycosylation of hemoglobin in vivo. J Clin Invest. 1976;57(6):1652-9.

Shapiro R, McManus M, Garrick L, McDonald MJ, Bunn HF. Nonenzymatic glycosylation of human hemoglobin at multiple sites. Metabolism. 1979;28(4 Suppl 1):427-30

Fitzgibbons JF, Koler RD, Jones RT. Red cell age-related changes of hemoglobinsAIa+b and AIc in normal and diabetic subjects. J Clin Invest. 1976;58(4):820-4.

Gram-Hansen P, Eriksen J, Mourits-Andersen T, Olesen L. Glycosylated haemoglobin (HbA1c) in iron- and vitamin B12 deficiency. J Intern Med. 1990;227(2):133-6.

Coban E, Ozdogan M, Timuragaoglu A. Effect of iron deficiency anemia on the levels of hemoglobin A1c in nondiabetic patients. ActaHaematol. 2004;112(3):126-8.

Ng JM, Jennings PE, Laboi P, Jayagopal V. Erythropoetin treatment significantly alters measured glycatedhaemoglobin (HbA1c). Diabet Med. 2008;25(2):239-40.

Kim MK, Kwon HS, Baek K, Lee JH, Park WC, Sohn HS, et al. Effects of thyroid hormone on A1C and glycated albumin levels in nondiabetic subjects with overt hypothyroidism. Diabetes Care. 2010;33:2546–8.

Bunn HF, Haney DN, Kamin S, Gabbay KH, Gallop PM. The biosynthesis of human hemoglobin A1c. Slow glycosylation of hemoglobin in vivo. J Clin Invest. 1976;57(6):1652-9.

Ismail M, Ahamed HBI, Rao V, Lakshmikanth RMN, Jagirdar SA. Effects of thyroid hormone on glycatedhaemoglobin in non-diabetic subjects with overt hypothyroidism. J. Evolution Med. Dent. Sci. 2017;11(6):882-7.

Velija-Asimi Z, Karamehic J. The effects of treatment of subclinical hypothyroidism on metabolic control and hyperinsulinemia. Med Arh. 2007;61:20–1.

BilicKomarica E, Beciragic A, Junuzovic D. Effects of treatment with L thyroxin on glucose regulation in patients with subclinical hypothyroidism Med Arch 2012 ;66(6):364 8.

Uppal V, Vij C, Bedi KV, Vij A and Banerjee BD. Thyroid Disorders in Patients of Type 2 Diabetes Mellitus. Ind J ClinBiochem. 2013; 28(4):336–341.


  • There are currently no refbacks.