Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Nov 15, 2020; 11(11): 527-539
Published online Nov 15, 2020. doi: 10.4239/wjd.v11.i11.527
Type 1 diabetes and associated autoimmune diseases
Lara Frommer, George J Kahaly
Lara Frommer, George J Kahaly, Department of Medicine I, Johannes Gutenberg Medical Center, Mainz 55131, Germany
Author contributions: Frommer L conception and design, acquisition of data, analysis and interpretation of data, drafting the article; Kahaly GJ project initiation, conception and design, drafting the article and revising it critically for important intellectual content; approval of the version to be published.
Institutional review board statement: The study needed no approval of the German Ethics committee.
Conflict-of-interest statement: The authors have no conflict-of interest to disclose.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: George J Kahaly, MD, PhD, Full Professor, Department of Medicine I, Johannes Gutenberg Medical Center, No. 1 Langenbeckstreet, Mainz 55131, Germany. gkahaly@uni-mainz.de
Received: June 25, 2020
Peer-review started: June 25, 2020
First decision: August 22, 2020
Revised: August 27, 2020
Accepted: October 13, 2020
Article in press: October 13, 2020
Published online: November 15, 2020
Abstract
BACKGROUND

Common autoimmune diseases (AID) tend to occur together in the same individual and families. Type 1 diabetes (T1D) is caused by an autoimmune-induced inflammatory destruction of the pancreatic tissue and clusters with several other AID.

AIM

To compare the demographic, clinical, and serological features of patients with single T1D vs those with T1D and associated AID.

METHODS

From October 1999 to February 2020, a total of 665 patients with T1D and their first-degree relatives were evaluated.

RESULTS

Compared to patients with isolated T1D, those with T1D + AID were older and had a higher female: male ratio. Average patient age and age at disease onset were higher in T1D + AID vs T1D only. The average time interval between T1D onset and the onset of a second glandular AID was markedly shorter than the time interval between T1D and the occurrence of a non-endocrine AID. T1D-specific autoantibodies were more frequent in patients with T1D + AID and relatives vs those with T1D only. However, the prevalence of AID and autoantibodies against various tissues were found to be higher in relatives of patients with T1D only compared to relatives of patients with T1D + AID.

CONCLUSION

Annual serological and subsequent functional screening for AID in patients with T1D and their first-degree relatives is recommended.

Keywords: Type 1 diabetes, Autoimmunity, Serology, Antibodies, Autoimmune endocrine diseases, Autoimmune non-endocrine disorders

Core Tip: Type 1 diabetes (T1D) often occurs in combination with several other endocrine and non-endocrine autoimmune disorders. Recent studies have revealed a strong clustering of T1D + autoimmune diseases in patients and their first-degree relatives. Therefore, regular screening for autoantibodies in patients with T1D and first-degree relatives is of upmost importance for diagnostic and therapeutic procedures of endocrine and non-endocrine autoimmunity.