Characteristics of patients with type 1 diabetes and additional autoimmune disease in the DPV registry

2021 ◽  
Author(s):  
Nicole Prinz ◽  
Sascha R Tittel ◽  
Rainer Bachran ◽  
Robert Birnbacher ◽  
Joachim Brückel ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Autoimmune Diseases ◽  
Diabetes Duration ◽  
Insulin Dosage ◽  
Insulin Regimen ◽  
Autoimmune Thyroid ◽  
Population Type ◽  
Multivariable Regression ◽  
Multivariable Regression Models

Abstract Context Autoimmune diseases affect ~8% of the population. Type 1 diabetes mellitus (T1DM) is linked to other autoimmune diseases (AID) like autoimmune thyroid disease, or Addison’s disease (AD) that may impact diabetes therapy and outcome. Objective To analyze demographic and clinical characteristics of other AID in T1DM from a large standardized registry, the prospective diabetes follow-up (DPV). Methods We searched the registry for T1DM with the additional diagnosis of Hashimoto’s thyroiditis (HT), Graves’ disease (GD), and/or AD. T1DM with other AID (n=6,166, 5.4%) were compared to isolated T1DM (n=107,457). For group comparisons, we used multivariable regression models with age, sex, diabetes duration, migration background, and type of insulin regimen as basic adjustments (microvascular endpoints: additionally adjusted for HbA1c). Results Patients with additional AID were more often female (54.7 vs. 32.0%, p<0.001) and had a longer diabetes duration (7.9 [4.2-12.5] vs. 6.7 [2.7-12.9] years, p<0.001). After adjustment, daily insulin dosage was higher in AD and HT compared to isolated T1DM (0.858±0.032 and 0.813±0.005 vs. 0.793±0.001 IU/kg*d). Retinopathy was less common in HT (1.5%), whereas it was more frequent in GD (3.1%) if compared to isolated T1DM (1.8%). In both GD and HT, microalbuminuria occurred less often (10.6% and 14.3% vs. 15.5%) and neuropathy (2.1% and 1.8% vs. 0.8%) was more common compared to isolated T1DM. Conclusions T1DM with additional AID show heterogeneous differences compared to isolated T1DM. T1DM plus AD or HT requires more insulin. Further, the rate of neuropathy is higher in HD or GD, whereas the rate of microalbuminuria is lower.

scholarly journals Autoimmune thyroid disease and type 1 diabetes mellitus: same pathogenesis; new perspective?

2020 ◽  
Vol 11 ◽  
pp. 204201882095832
Author(s):  
Liyan Li ◽  
Shudong Liu ◽  
Junxia Yu
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Autoimmune Diseases ◽  
Type 1 Diabetes Mellitus ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Current Knowledge ◽  
Tyrosine Phosphatase ◽  
Autoimmune Thyroid

Autoimmune thyroid disease (AITD) and type 1 diabetes mellitus (T1DM) are two common autoimmune diseases that can occur concomitantly. In general, patients with diabetes have a high risk of AITD. It has been proposed that a complex genetic basis together with multiple nongenetic factors make a variable contribution to the pathogenesis of T1DM and AITD. In this paper, we summarize current knowledge in the field regarding potential pathogenic factors of T1DM and AITD, including human leukocyte antigen, autoimmune regulator, lymphoid protein tyrosine phosphatase, forkhead box protein P3, cytotoxic T lymphocyte-associated antigen, infection, vitamin D deficiency, and chemokine (C-X-C motif) ligand. These findings offer an insight into future immunotherapy for autoimmune diseases.

scholarly journals SAT-683 A Case of Autoimmune Polyglandular Syndrome Type 2 and Guillain-Barré Syndrome

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jason Cutler ◽  
Erika Brutsaert
Keyword(s):  
Type 1 Diabetes ◽  
Autoimmune Diseases ◽  
Guillain Barre Syndrome ◽  
Free T4 ◽  
Autoimmune Thyroid ◽  
Autoimmune Polyglandular Syndrome ◽  
Guillain Barré Syndrome ◽  
Autoimmune Polyglandular Syndrome Type ◽  
Guillain Barré

Abstract Background: Autoimmune polyglandular syndrome type 2 (APS2) is defined by the occurrence of two or more autoimmune diseases, with Addison’s disease being most prevalent, and autoimmune thyroid disease and type 1 diabetes mellitus also being common. Guillain-Barré syndrome (GBS) is an acute inflammatory demyelinating polyradiculopathy that is also autoimmune in nature, resulting in ascending muscle weakness or paralysis. Clinical Case: A 49 year old female with past medical history of vitiligo, subclinical hyperthyroidism, and Guillain-Barré syndrome (GBS) presented to our institution with fatigue, nausea, vomiting, polyuria, and polydipsia. She had no history of diabetes. Her history was also significant for GBS, diagnosed 5 months prior to her current admission. She was treated with intravenous immunoglobulin (IVIG) and had partial improvement of motor impairment. On exam, she was noted to have dry mucous membranes, epigastric tenderness, and patches of hyopigmented skin. Laboratory studies were consistent with diabetic ketoacidosis, and she was admitted to the ICU for management. Labs from 5 months prior were significant for a HbA1c of 6.4% (4.0-5.6%), TSH <0.002 mIU/L (0.350-4.7 mIU/L), total T3 154.9 ng/dL (79-149 ng/dL), and free T4 1.7 ng/dL (0.7-1.9 ng/dL), and elevated thyroid stimulating immunoglobulin. During the current admission, HbA1c had risen to 13.6%, C-Peptide 0.6 ng/mL (1.1-4.4 ng/mL) and GAD-65 antibody >250 IU/mL (<5 IU/mL), consistent with a diagnosis of late-onset type 1 diabetes. Repeat thyroid function tests (TSH <0.002 mIU/L, total T3 74 ng/dL, and free T4 1.2 ng/dL), were consistent with subclinical hyperthyroidism. A 21-hydoxylase antibody level was 13 U/mL (<1 U/mL), but cortisol rose appropriately in response to cosyntropin. Based on the patient’s constellation of vitiligo, autoimmune thyroid disease, type 1 diabetes, and elevated 21-hydroxylase antibodies, she was diagnosed with APS2. Conclusion: We present an unusual case of a patient with APS2, who was diagnosed with type 1 diabetes 5 months after developing GBS and being treated with IVIG. Prior reports demonstrate an association between GBS and other autoimmune diseases, including one case report of GBS in a patient with APS2. HLA DR3 has been associated with APS2, type 1 diabetes, Addison’s disease and Grave’s disease. Its association with GBS is less clear, although HLA DR3 was increased in one Mexican cohort with GBS. This case report adds to the literature suggesting an association with GBS and other autoimmune diseases, specifically, with APS2. References: Jin PP, Sun LL, Ding BJ, Qin N, Zhou B, et al. (2015) Human Leukocyte Antigen DQB1 (HLA-DQB1) Polymorphisms and the Risk for Guillain-Barré Syndrome: A Systematic Review and Meta-Analysis. PLOS ONE 10(7): e0131374 Melmed, S., Polonsky, K. S., Larsen, P. R., & Kronenberg, H. (2016). Williams textbook of endocrinology. Philadelphia, PA: Elsevier

scholarly journals Prevalence of coexisting autoimmune thyroidal diseases in coeliac disease is decreasing

2020 ◽  
Vol 8 (2) ◽  
pp. 148-156 ◽  
Author(s):  
Patricia Dominguez Castro ◽  
Grace Harkin ◽  
Mary Hussey ◽  
Brian Christopher ◽  
Clifford Kiat ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
General Population ◽  
Autoimmune Diseases ◽  
Coeliac Disease ◽  
Immune Mediated ◽  
Population Type ◽  
Increased Risk ◽  
General Populations ◽  
Over Time

Background Coeliac disease (CD) is associated with an increased risk of other immune-mediated conditions. Aim: To investigate the prevalence of coexistent immune-mediated diseases in CD patients, and changes in the prevalence of autoimmune thyroidal diseases over the last 50 years. Methods Medical record data were collected retrospectively from 749 CD patients in Ireland. Prevalence of autoimmune diseases was compared with previously published results from general populations. Patients were divided into four groups based on the year of diagnosis to analyse changes in the prevalence of autoimmune thyroidal disease over time. Results Median age at the time of CD diagnosis was 56 years (range 18–91 years). A total of 233 (31.1%) patients had a coexistent immune-mediated condition (IMC). Autoimmune thyroidal diseases were seen in 149 (19.9%) patients, hypothyroidism in 110 (14.7%), type 1 diabetes in 27 (3.6%), psoriasis in 20 (2.7%), inflammatory bowel disease in 14 (1.9%) and rheumatoid arthritis in 12 (1.6%). All conditions were more common in CD patients than in the general population. Type 1 diabetes was diagnosed mainly before CD, whereas there was no such trend in other conditions. Autoimmune thyroidal diseases became less common in female CD patients over time. Conclusions Prevalence of autoimmune diseases is increased in adult CD patients compared with the general population. However, concomitant autoimmune thyroidal diseases became less common over time in women.

scholarly journals Autoimmune diseases associated with type 1 diabetes mellitus: possible interplay

2013 ◽  
Vol 59 (1) ◽  
pp. 35-43 ◽  
Author(s):  
A A Larina ◽  
E A Troshina
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Autoimmune Diseases ◽  
Type 1 Diabetes Mellitus ◽  
Metabolic Control ◽  
Early Diagnostics ◽  
Autoimmune Thyroid ◽  
Endocrine Diseases ◽  
Autoimmune Polyglandular Syndrome

Type 1 diabetes mellitus is not infrequently associated with other autoimmune endocrine and non-endocrine diseases included in the notion of "autoimmune polyglandular syndrome" (APS). Their incidence in the patients presenting with this syndrome is significantly higher than that of isolated autoimmune pathologies. The enhanced risk of the development of these diseases is associated with the presence of genetic markers, such as HLAII-complex haplotypes, CTLA-4, PTPN22, FOXP2, and certain other genes. Decompensation of autoimmune thyroid disorders and adrenal insufficiency, as well as the presence of celiac disease, autoimmune gastritis and pernicious anemia in the patients with type 1 diabetes mellitus may be responsible for the impairment of metabolic control. It is recommended that the patients with DM1 be regularly examined for the early diagnostics of autoimmune diseases including components of APS and the associated subclinical functional disturbances with a view to preventing deterioration of metabolic control.

Efficacy of sotagliflozin 400 mg/day in 1402 patients with type 1 diabetes treated with any insulin regimen (inTandem 3)

2018 ◽  
Author(s):  
SK Garg ◽  
RR Henry ◽  
P Banks ◽  
JB Buse ◽  
MJ Davies ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Regimen

1217-P: Improvement of Metabolic Control in Type 1 Diabetes after Transition Is Independent from Referral Center and Insulin Regimen

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1217-P
Author(s):  
SILVIA PIERALICE ◽  
ERNESTO MADDALONI ◽  
CHIARA MORETTI ◽  
ANNA RITA MAURIZI ◽  
CARMEN MIGNOGNA ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Metabolic Control ◽  
Insulin Regimen ◽  
Referral Center

Features of the ovarian reserve of women of reproductive age suffering from autoimmune diseases

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 27-30
Author(s):  
Elena N. Andreeva ◽  
Olga R. Grigoryan ◽  
Yulia S. Absatarova ◽  
Irina S. Yarovaya ◽  
Robert K. Mikheev
Keyword(s):  
Type 1 Diabetes ◽  
Thyroid Gland ◽  
Autoimmune Diseases ◽  
Ovarian Reserve ◽  
Reproductive Potential ◽  
Reproductive Age ◽  
Control Group ◽  
Antithyroid Antibodies ◽  
Healthy Women

The reproductive potential of a woman depends on indicators of the ovarian reserve, such as the anti-Muller hormone (AMH) and the number of antral follicles (NAF). Autoimmune diseases have a significant effect on fertility and contribute to the development of premature ovarian failure. Aim.To evaluate the parameters of the ovarian reserve in patients with type 1 diabetes mellitus, carriers of antibodies to the thyroid gland in a state of euthyroidism and compare them with similar parameters in healthy women. Materials and methods.In the first block of the study, the level of AMH, follicle-stimulating hormone, luteinizing hormone, NAF was studied among 224 women with diabetes and 230 healthy women in the control group. In block II, the level of the above hormonal indices was studied in 35 carriers of antithyroid antibodies in the state of euthyroidism and 35 healthy women. Results.In patients with type 1 diabetes, the level of AMH, NAF was statistically significantly lower when compared with the control group. Among carriers of antithyroid antibodies and healthy women, no difference in AMH and NAF was found. Conclusion.The autoimmune processes accompanying diabetes are more influenced by the ovarian reserve indices than autoimmune aggression to the tissues of the thyroid gland.

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