Thyrotoxicosis, as we discussed in Chapter 4, can increase your need for insulin if you have type 1 diabetes or in some cases of type 2 diabetes. If you have type 2 diabetes (as one in four adults over forty-five do), you are already at a much greater risk of heart attack or stroke because of blood vessel complications. It is critical that you have your diabetes medications or insulin and your blood-sugar targets reassessed by your doctor, since they can be thrown off by the symptoms of Graves' disease and thyrotoxico-sis. If you have diabetic eye disease, it's important to assess whether new eye symptoms are a result of developing thyroid disease or a worsening of preexisting diabetes eye disease (also worsened by smoking).
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