A LOW T3 SYNDROME IN DIABETIC KETOACIDOSIS

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Abstract
The pituitary-thyroid axis was investigated in 19 euthyroid patients with severe diabetic ketoacidosis. A low T3 [triiodothyronine] syndrome was found, with the following characteristics: lowered serum concentrations of triiodothyronine (T3), increased reverse triiodothyronine (rT3), slightly low thyroxine (T4), normal thyrotrophin (TSH), slightly increased triiodothyronine uptake (RT3U) values, and a blunted TSH response to thyrotrophin-releasing hormone (TRH). These disturbances in thyroid-function tests required several days good control of the diabetes to be corrected, at least partially. The presence of an abnormal extrathyroidal T4 metabolism as well as a pituitary defect were suggested. Caution is recommended in the interpretation of thyroid-function tests during and several days after the treatment of diabetic ketoacidosis.