In a cohort of 1,422 euthyroid inpatients with type 2 diabetes, over one-third met criteria for diabetic peripheral neuropathy based on symptoms and detailed electromyography. Those with neuropathy had lower free triiodothyronine levels within the reference range, longer diabetes duration, poorer glycaemic control, and more microvascular and cardiovascular comorbidity than those without neuropathy. Free triiodothyronine correlated positively with nerve conduction amplitudes and velocities and inversely with distal latencies, and lower values remained independently associated with neuropathy after multivariable adjustment.
Complementary Mendelian randomization analyses supported a probable causal link between reduced free triiodothyronine and neuropathy risk. Reflect on whether subtle thyroid hormone variation in the euthyroid range should influence your threshold for neuropathy…
