Characteristics of Patients with Type 1 Diabetes and Additional Autoimmune Disease in the DPV Registry

Context: Autoimmune diseases affect similar to 8% of the population. Type 1 diabetes mellitus (T1DM) is linked to other autoimmune diseases (AIDs), such as autoimmune thyroid disease or Addison's disease (AD), that may impact diabetes therapy and outcome. Objective: To analyze demographic and clinical characteristics of other AIDs in T1DM from a large standardized registry, the Prospective Diabetes Follow-up Registry (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 AIDs (n = 6166, 5.4%) were compared with 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 glycated hemoglobin). Results: Patients with additional AIDs were more often female (54.7 vs 32.0%, P< .001) and had a longer diabetes duration (7.9 [4.2-12.5] vs 6.7 [2.7-12.9] years, P< .001). After adjustment, daily insulin dosage was higher in AD and HT than in isolated T1DM (0.858 +/- 0.032 and 0.813 +/- 0.005 vs 0.793 +/- 0.001 IU/kg per day). Retinopathy was less common in HT (1.5%), whereas it was more frequent in GD (3.1%) than in 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 than in isolated T1DM. All P < .05. Conclusion: T1DM with additional AIDs show heterogeneous differences compared with isolatedT1DM.T1DM plus AD or HT requires more insulin. Further, the rate of neuropathy is higher in HT or GD, whereas the rate of microalbuminuria is lower.

Automated summary

Autoimmune diseases, including Type 1 diabetes mellitus, are common and may be linked to other autoimmune diseases like autoimmune thyroid disease or Addison's disease. Patients with additional autoimmune diseases in T1DM may require higher insulin doses and have varying rates of complications such as neuropathy and microalbuminuria.