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Factors Limiting the Diagnosis of TD in Patients With DM
| • The clinical diagnosis may be delayed because symptoms are masked by DM |
| • Diabetes-induced alterations of HPT axis with reduced levels of TRH and TSH |
| • Decreased T4-to-T3 conversion, especially in poorly controlled diabetes |
| • Low T3 syndrome in diabetic ketoacidosis |
| • Potential interference of TH binding inhibitor on T3 production |
| • Effect of oral hypoglycemic agents on serum TSH levels |
