TRH and type 2 diabetes mellitus: While the link with T2DM is less clearly defined, potential contributing factors include an altered thyrotropin-releasing hormone (TRH) response, loss of the nocturnal thyroid-stimulating hormone (TSH) surge, and a low triiodothyronine (T3) state often associated with insulin resistance [3,4]. Importantly, the interplay is bidirectional.