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 In type 1 diabetes, the immune system attacks the pancreas and
destroys its insulin-producing cells. Patients often develop other
immune system diseases, too. Indeed, in the current study, 27
percent of patients had at least one other autoimmune disorder.
But the new study also held some surprises about how early and late
in life these added health problems might surface, said lead author
Dr. Jing Hughes of Washington University School of Medicine in St.
Louis.
“The pattern that emerged was striking: autoimmune diseases begin
early in childhood, where nearly 20 percent of those under age 6
already have additional diseases other than type 1 diabetes,” Hughes
said by email.
“Another surprise finding was that, while we had expected that
autoimmune diseases may peak at a certain time of life, we found
instead that the autoimmune burden continues to increase as patients
age, to the extent that nearly 50 percent of those over age 65 have
accumulated one or more additional autoimmune disease,” Hughes
added.
The findings are drawn from data on nearly 26,000 adults and
children being treated for type 1 diabetes at 80 endocrinology
practices in the U.S. between 2010 and 2016.
Of those with other autoimmune disorders in addition to diabetes, 20
percent had one additional problem and 5 percent had at least two
additional diseases, researchers report in the Journal of Clinical
Endocrinology and Metabolism.
Participants with one or more additional autoimmune disorders were
more likely to be older, female and white, the study found. They
also tended to have been diagnosed with type 1 diabetes at an older
age, and to have lived with the condition for longer.
Thyroid diseases were the most common autoimmune disorders,
affecting about 24 percent of the participants. In most of these
cases, the thyroid gland was underactive, which can lead to
constipation, weakness, weight gain, depression and a slowed heart
rate.
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Celiac disease was the second most common autoimmune problem,
affecting about 6 percent of participants. Celiac disease damages
the small intestine and interferes with the absorption of nutrients
if patients consume gluten, a protein in wheat, rye and barley; it
can lead to complications like malnutrition, low bone density,
lactose intolerance and infertility.
Other diseases included Graves disease (overactive thyroid),
rheumatoid arthritis and vitiligo.
One limitation of the study is that researchers lacked data on how
old patients were when the autoimmune disorders developed, making it
impossible to determine if participants gradually accumulated these
diseases over time or if they were clustered around a certain age,
the authors note.
Even so, the findings suggest that people with type 1 diabetes
should get routine screening for other autoimmune diseases –
particularly celiac disease and thyroid disorders – the authors
conclude.
“The take home message is that kids with type 1 diabetes are at
increased risk for developing other autoimmune diseases compared to
kids who don't have type 1 diabetes,” said Dr. Laurie Tsilianidis,
an endocrinologist at Cleveland Clinic Children’s in Ohio who wasn’t
involved in the study.
“This is particularly true once they become adults, and Caucasian
women carry the greatest risk,” Tsilianidis added by email.
SOURCE: http://press.endocrine.org/doi/10.1210/jc.2016-2478 Journal
of Clinical Endocrinology and Metabolism, online September 27, 2016.
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