Insulin resistance (IR) with compensatory hyper-insulinemia are key factors involved in the pathogenesis of glucose metabolism disorders (including impaired fasting glucose and glucose tolerance and frank diabetes mellitus) as well as increased thyroid gland volume and nodule prevalence in patients with metabolic syndrome. On the other hand, thyroid hormone contributes to the regulation of carbohydrates metabolism and pancreatic function. This cross-sectional study investigated the possible association between the different glucose metabolic disorders (GM) and thyroid gland volume. The study was conducted on 400 subjects over one year duration, divided into 50% diabetic patients in comparison to 25% pre-diabetics and 25% cross-matched control. All the subjects were investigated by fasting and postprandial blood sugar and fasting insulin level (for HOMA-IR calculation) as well as TSH assay combined with thyroid ultrasound. The results showed that thyroid volume was significantly larger in patients with diabetes compared to the control as well as significant positive correlation between thyroid volume and FBS, fasting insulin, HOMA-IR, 2hours pp BS and HbA1cin. Besides, there was significant association between serum TSH levels and thyroid volume. The main regulator of thyroid cell growth and differentiation is TSH. The elevated insulin levels due to IR lead to an increase in IGF-1 levels (which is an important hypertrophic and progression factor for a series of cell types including thyroid cells with increased risk of malignancy in such patients).