AI Summary & Key Takeaways
AI InsightFurthermore, we suggest investigation for pernicious anemia, vitiligo, and celiac disease in women with T1D.
📌 3 Key Takeaways
Abstract
Introduction: Diabetes guidelines recommend routine screening for autoimmune thyroid disease (ATD) and celiac disease, especially in cases of childhood-onset type 1 diabetes (T1D). However, the level of evidence is weak (expert opinion), and for adult-onset T1D even less clear. The aim of this study is to evaluate the prevalence of comorbid autoimmune diseases (ADs) in childhood-onset and adult-onset T1D patients, and to compare the distribution of individual ADs with those with type 2 diabetes mellitus (T2D). Methods: Among a total of 1594 adult diabetes patients who were consecutively followed by a single Diabetes Center, 22% (n=351) had T1D. Patients with T1D were screened for ATD, pernicious anemia, vitiligo, celiac, and when clinically relevant for Addison’s, and other organ-specific/systemic autoimmune/autoinflammatory diseases. To compare the distribution of ADs, we included a group of 50 T2D patients with at least one known autoimmunity. In addition, the relationship between ADs, and the level of glycemic control and the presence of micro- and macrovascular complications were investigated. Results: The prevalence of AD was 26.2% in T1D with females being more affected than males. ATD was the most prevalent, followed by pernicious anemia, vitiligo, celiac, and premature gonadal failure. Over 60% had single (mostly ATD; T1D 83.6%, T2D 68.6%), and over 20% had double AD with no significant difference between T1D and T2D. Of T1D patients, 8.2% had triple AD. The majority of ATDs was Hashimoto’s thyroiditis and/or hypothyroidism, only 12% had Graves’ disease (T1D 10.9% and T2D 14%). In T1D women, pernicious anemia (22.8%), vitiligo (9.8%), and celiac (8.7%) were the most common comor- bidities of ATD. There was no significant relationship between the frequency of ADs and individual ADs and glycemic control, age-at-onset of diabetes, and micro- and macrovascular complications. Discussion and Conclusion: Screening for ATD should be included in the routine management protocol of adult-onset T1D as recommended in those with childhood-onset. Furthermore, we suggest investigation for pernicious anemia, vitiligo, and celiac disease in women with T1D.