IP Journal of Surgery and Allied Sciences

Online ISSN: 2582-6387

IP Journal of Surgery and Allied Sciences (JSAS) open access, peer-reviewed quarterly journal publishing since 2019 and is published under the Khyati Education and Research Foundation (KERF), is registered as a non-profit society (under the society registration act, 1860), Government of India with the vision of various accredited vocational courses in healthcare, education, paramedical, yoga, publication, teaching and research activity, with the aim of faster and better dissemination more...


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Banerjee: Importance of proper diet after thyroidectomy in diabetic patients: A short communication


Introduction

There are growing cases with thyroidectomy, a surgical procedure to remove whole or partial thyroid gland often observed in postmenopausal women. There is also a matter to think about post-surgery proper nutrition to get all nutrients in a balanced diet. In addition, diabetes is a significant concern when the same patient is also undergoing to do thyroidectomy.

Mullur et al. (2014) explained that patients with hyperthyroidism often gain weight after thyroid surgery. Low levels of free T4 and T3 are thought to cause weight gain, counteracting the weight-loss effects of higher thyroid hormones. Rotondi et al. (2014) discussed that patients usually become obese after thyroid surgery, even when they have euthyroidism measuring the biochemical parameters. Most of the studies show such issues with mixed results, and some of the papers also have selection bias either at intervention or sampling grounds.1

The highest observation on weight gain was seen in menopausal women patients who did their thyroidectomy. Such postmenopausal patients reported more weight than premenopausal women. While there is no other alternative except the removal of the thyroid gland due to thyroid cancer, Graves’ disease, or a multinodular goiter that causes pressure symptoms, then in these cases, replacement therapy may restore normal levels of TSH, T4, and T3.2 Thyroid damage can also occur due to other factors. Antibodies directed against thyroid tissue antigens and antibodies that react with the thyrotropin receptor by binding to the receptor characterize the aberrant immune response. Some of these antibodies stimulate the thyroid gland by acting as agonists. It is thought that this condition is caused by an anomaly in the management of autoimmune responses, which leads to the development of large amounts of autoantibodies, which may stimulate the thyroid or, in the worst-case scenario, cause thyroid damage and cell death.3, 4, 5

Figure 1

Post thyroidectomy, the significant complications

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/462fd435-1131-46e4-bcac-92df89690bb2/image/915d3af7-2664-41cd-8e68-36ec05881d9a-uimage.png

In their research study, Chung et al. (2019) showed that diabetes patients exhibited considerably more significant rates of concomitant chronic pulmonary illness, hypertension, obesity, and anemia at the start of the study. Patients with DM were more likely than non-DM patients to have vocal cord paresis or paralysis after thyroid surgery (2% vs. 1.3%; P value=.001).6 Katamadze and Marshania (2017) presented a case report in which a diabetic 56-year-old patient underwent thyroidectomy due to papillary microcarcinoma. The patient complained of erectile dysfunction after many days of thyroidectomy. Early detection of ED is critical for successful therapy, particularly in men with ED and several significant endocrine problems. In this example, the patient had a thyroidectomy and soon after the visited clinic.7

The best nutrition shall be eating soft meals such as pudding, gelatin, mashed potatoes, apple sauce, or yogurt in more or less quantity subject to patients. Constipation can be solved by eating high-fiber foods and drinking plenty of fluids. Some web content found in google that the keto diet may be helpful; however, a simple low carbohydrate, low fat, and protein-rich diet would manage the excess weight in case of weight gain at post thyroidectomy.8, 9

Similar to the ‘Western-pattern,’ the ‘animal food pattern' includes red meats and eggs. Intake of both processed and unprocessed red meat has been linked to an increased risk of obesity. Other features of the 'Western' pattern, fried and fast foods, are not found in this ‘animal food pattern'. Furthermore, several items that load firmly on the ‘Prudent’ practice, such as fish, are also part of the animal food pattern and have been linked to lower weight gain compared to meat intake.10 Other research, on the other hand, has discovered primarily animal-food trends. However, such diets may be helpful for a specific type of people but not suitable for all after thyroidectomy. The dietary patterns found in this study were dissimilar from those observed in other nations, with a clear separation between vegan and non-veg diet types emerging, with the exhibiting favorable connections with obesity and central obesity. If more research in India confirms these findings, India’s dietary guidelines may propose restricting animal-food intake in favor of a primarily plant-based diet.11, 12 Proper understanding and subsequent follow-up of low glycemic-indexed and Aggregate Nutrient Density Index (ANDI) listed food are the best ways to make a dietary model for such patients. In general, awareness of diabetic food and lifestyle modifications are the primary aims and objectives of dietitians and public health workers to make people aware of these include thyroidectomy persons.13, 14

Conclusion

There are no specific diet patterns or plans for thyroidectomy patients with or without diabetes (DM-II). The best way is to practice a low-calorie diet that contains low carbohydrates, mainly simple sugar and low fat but with enough veg protein. In this issue, more researches are needed.

Source of Funding

None.

Conflict of Interest

None.

References

1 

R Mullur YY Liu GA Brent Thyroid hormone regulation of metabolismPhysiol Rev20149423558210.1152/physrev.00030.2013

2 

M Rotondi L Croce C Pallavicini LL Manna SM Accornero R Fonte Endocr Pract Body weight changes in a large cohort of patients subjected to thyroidectomy for a wide spectrum of thyroid diseasesEndocr Pract201420111151810.4158/EP14125.OR

6 

SY Chung A Govindan A Babu A Tassler Thyroidectomy Complications in Patients with Diabetes MellitusOtolaryngol-Head Neck Surg20191611465110.1177/0194599819835793

7 

N Katamadze Z Marshania Rare case of manifestation of erectile dysfunction soon after thyroidectomy because of thyroid cancer in 56-year-old man with diabetes mellitus type 2 and diabetic neuropathy Endocr Abstracts20174910.1530/endoabs.49.EP797

8 

FI Ahmad ME Zafereo SY Lai PW Flint HW Francis BH Haughey Management of thyroid neoplasmsCummings Otolaryngology: Head and Neck Surgery7th editionElsevierPhiladelphia, PA2021

9 

W Liddy J Bonilla-Velez F Triponez D Kamani G Randolph GW Randolph Principles in thyroid surgerySurgery of the Thyroid and Parathyroid Glands3rd editionElsevierPhiladelphia, PA2021

10 

NS Ospina A Castaneda-Guarderas O Hamidi OJ Ponce W Zhen L Prokop Weight Changes After Thyroid Surgery for Patients with Benign Thyroid Nodules and Thyroid Cancer: Population-Based Study and Systematic Review and Meta-AnalysisThyroid201828563949

11 

D Mozaffarian T Hao EB Rimm WC Willett FB Hu Changes in diet and lifestyle and long-term weight gain in women and menN Engl J Med201136425239240410.1056/NEJMoa1014296

12 

M Rosell P Appleby E Spencer T Key Weight gain over 5 years in 21,966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-OxfordInt J Obes (Lond)2006309138996

13 

S Banerjee Nutrition Facts, Health Benefits and Aggregate Nutrient Density Index (ANDI) of Roots and Tubers VegetablesAgric Food202021258890

14 

S Banerjee Uses of technologies & social media for diet and exercise awareness among obese, hypothyroid and pre-diabetic women - A case study in West BengalJ Xi’an Univ Archit Technol202012346828



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© This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article type

Short Communication


Article page

93-95


Authors Details

Swapan Banerjee*


Article History

Received : 29-08-2021

Accepted : 29-09-2021

Available online : 18-10-2021


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