Known as hypothyroidism, an underactive thyroid may increase the risk of type 2 diabetes, according to a recent study presented this year at a meeting of the Endocrine Society. This connection is so strong that medical experts are now suggesting that doctors begin screening people with prediabetes for low thyroid function, HealthDay News reports.

Insufficient thyroid hormone production can interfere with the body’s ability to convert food into the energy we need to power movement, thought and growth. In addition, such a deficiency can seriously compromise many cellular functions—including our ability to absorb and use other hormones. One of these hormones is insulin, which helps regulate the body’s blood sugar levels. (Insulin resistance is one of the hallmarks of type 2 diabetes.)

For the study, researchers at Erasmus Medical Center in the Netherlands tracked 8,452 people, with an average age of 65. Scientists measured participants’ thyroid and blood sugar patterns for several years. During a follow-up period of almost eight years, 1,100 of these volunteers developed prediabetes. (This condition occurs when your blood sugar level is higher than it should be but not so high it’s considered diabetes.) In addition, 798 participants developed type 2 diabetes.

Findings showed that people who suffered from hypothyroidism or experienced thyroid levels classified as being in the “low-normal” range were more likely to develop diabetes. But participants with higher levels of thyroid hormone enjoyed a reduced risk of diabetes. In addition, researchers noted that the risk of progression from prediabetes to diabetes was 40 percent higher among those with the lowest thyroid functions.

“These findings suggest we should consider screening people with prediabetes for low thyroid function,” said Layal Chaker, MD, an endocrinology expert at the medical center.

In addition to hypothyroidism leading to an increased risk of diabetes, the illness can result in fatigue, weight gain, weakness, muscle cramps and depression, problems that may also boost a person’s diabetes risk.

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