High prevalence of comorbid autoimmune diseases in adults with type 1 diabetes from the HealthFacts database

Bao, Yicheng; Weide, Lamont G.; Ganesan, Vishwanath C.; Jakhar, Ishaan; McGill, Janet B.; Sethi, Sanjay; Cheng, An‐Lin; Gaddis, Monica; Drees, Betty M.

doi:10.1111/1753-0407.12856

Cited by 31 publications

(29 citation statements)

References 33 publications

(56 reference statements)

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“…5 Rates of type 1 diabetes, an autoimmune disease, often cluster with other autoimmune diseases such as celiac disease and thyroid disorders. [6][7][8][9] In the Type 1 Diabetes Registry, 34% of female and 19% of male patients with type 1 diabetes had additional autoimmune diseases. 6 In a study of adults with type 1 diabetes using a nationwide patient database, 30% of women and 15.8% of men had an additional autoimmune disease, with thyroid disease being the most common.…”

Section: Introductionmentioning

confidence: 99%

“…6 In a study of adults with type 1 diabetes using a nationwide patient database, 30% of women and 15.8% of men had an additional autoimmune disease, with thyroid disease being the most common. 7 In a pediatric study, one-third of children with type 1 diabetes had autoantibodies for common autoimmune disorders and 6% were diagnosed with another autoimmune disease within several months after the onset of type 1 diabetes. 9 Although both microvascular and macrovascular complications of type 1 diabetes have been described, 10,11 population-based studies of the influence of multiple autoimmune diseases on subsequent cardiovascular and renal disease have not been fully investigated.…”

Section: Introductionmentioning

confidence: 99%

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Sex Differences in Autoimmune Multimorbidity in Type 1 Diabetes Mellitus and the Risk of Cardiovascular and Renal Disease: A Longitudinal Study in the United States, 2001–2017

Rogers

Wei

Kim

et al. 2020

Journal of Women's Health

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Background: Autoimmune diseases are usually more prevalent in women. The risks of cardiovascular and renal disease in those with multiple autoimmune diseases have not been fully described. Materials and Methods: Using a national database from a large health insurer in the United States (years 2001-2017) containing *75 million members, we calculated age-and sex-specific co-prevalence of 12 autoimmune disorders for individuals with type 1 diabetes. We then evaluated whether concomitant autoimmune diseases were associated with renal failure, ischemic stroke, and myocardial infarction. Results: Of the 179,248 people diagnosed with type 1 diabetes, 1 in 4 had a concomitant autoimmune disease (27.03%; 95% confidence interval [CI] = 26.83%-27.24%), with hypothyroidism, rheumatoid arthritis, and celiac disease being the most common. The prevalence of autoimmune disease was 1.9 times greater in female than male patients ( p < 0.001). In female patients with type 1 diabetes, one in three had another autoimmune disease (35.62%; 95% CI = 35.30%-35.94%) compared with one in five male patients (19.17%; 95% CI = 18.92%-19.42%). The risk of renal failure, ischemic stroke, and myocardial infarction increased with a greater number of concomitant autoimmune diseases ( p < 0.001, test for trend for both female and male patients). Patients with type 1 diabetes who had multiple sclerosis or myasthenia gravis experienced an approximate threefold increase in risk of ischemic stroke (odds ratio [OR] = 3.57, OR = 3.22, respectively). Patients with type 1 diabetes and Addison's disease had a threefold increased risk of renal failure. Conclusions: Patients with type 1 diabetes, particularly women, frequently have coexisting autoimmune diseases that are associated with higher rates of renal failure, ischemic stroke, and myocardial infarction. Additional study is warranted, as are preventive efforts in this high-risk population.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sex Differences in Autoimmune Multimorbidity in Type 1 Diabetes Mellitus and the Risk of Cardiovascular and Renal Disease: A Longitudinal Study in the United States, 2001–2017

Rogers

Wei

Kim

et al. 2020

Journal of Women's Health

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“…1 Compared to the general population, children with type 1 diabetes (T1D) have higher prevalence of CD (up to 10% vs 0.9%). 2 CD was historically considered a disease that affected mainly Caucasians, particularly in North Europe 3 ; however, there is emerging evidence that the frequency of CD is also rising in Asia, 4 the Middle East, and Africa. 5 Craig et al described the prevalence of CD in patients with T1D (2013-2014) from the United States (1.9%), Australia (7.7%), Germany/Austria (3.2%), and the United Kingdom (3.8) and found that the frequency of CD in children with T1D differed among these countries.…”

Section: Introductionmentioning

confidence: 99%

Celiac disease in children with type 1 diabetes varies around the world: An international, cross‐sectional study of 57 375 patients from the SWEET registry

Taczanowska

Schwandt

Amed

et al. 2020

Journal of Diabetes

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Background: Children with type 1 diabetes (T1D) are at much higher risk of developing celiac disease (CD) than the general population. The aim of the study was to assess the prevalence and differences in clinical presentation of CD in T1D in different regions of the world. Methods: This study is based on the Better control in Pediatric and Adolescent diabeteS: Working to crEate cEnTers of Reference (SWEET) database. There were 57 375 patients included in the study, aged ≤18 years from 54 SWEET centers. Only centers with screening for celiac disease were included. Regression models adjusted for age, diabetes duration, and gender and a fixed effect in the models for region was used. Diabetes duration, age at diabetes onset, and sex were presented as unadjusted results. Results: CD was present in 2652 subjects (4.5%), with different prevalence among regions: from 1.9% in Asia/Middle East to 6.9% in Australia/New Zealand. CD was observed more often among females. Comparing children with and without CD, characteristics for those with CD were younger age at diabetes onset (6.3 [3.3; 9.8] vs 8.1 [4.6; 11.3], P < 0.001) and had longer diabetes duration (6.4 [3.6; 9.8] vs 4.8 [2.1; 8.2], P < 0.001). Further, they had lower glycosylated hemoglobin (HbA1c) in Europe and North America/Canada; lower body mass index (BMI)-SD score (BMI-SDS) in southern Europe, North America, and Canada; In most regions daily insulin dose was lower, height-SDS was lower, and the percentage of insulin pump users was higher in children with T1D and CD. Conclusions:The prevalence and the anthropometric and metabolic consequences of CD in children with T1D differ around the world.

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“…The incidence of T2D is at least twice that in patients with RA compared with the general population, and there is an increased risk for CVD in patients with both conditions relative to patients with either RA or T2D alone [ 121 , 165 ]. The coexistence of RA and T1D is less common than that of RA and T2D (Bao et al [ 166 ] reported that 2% of > 150,000 patients with T1D in the USA have RA), but the risk of more than one autoimmune disease in the same patient is an established phenomenon.…”

Section: Il-6 Beyond the Joint: Common Comorbidities Of Ramentioning

confidence: 99%

Understanding the Role of Interleukin-6 (IL-6) in the Joint and Beyond: A Comprehensive Review of IL-6 Inhibition for the Management of Rheumatoid Arthritis

Favalli

2020

Rheumatol Ther

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Rheumatoid arthritis (RA) is a chronic, debilitating autoimmune disorder involving inflammation and progressive destruction of the joints, affecting up to 1% of the population. The majority of patients with RA have one or more comorbid conditions, the most common being cardiovascular disease, osteoporosis, and depression, the presence of which are associated with poorer clinical outcomes and lower healthrelated quality of life. RA pathogenesis is driven by a complex network of proinflammatory cells and cytokines, and of these, interleukin-6 (IL-6) plays a key role in the chronic inflammation associated with RA. Through cell signaling that can be initiated by both membrane-bound and soluble forms of its receptor, IL-6 acts both locally to promote joint inflammation and destruction, and in the circulation to mediate extra-articular manifestations of RA, including pain, fatigue, morning stiffness, anemia, and weight loss. This narrative review describes the role of IL-6 in the pathogenesis of RA, its comorbidities, and extra-articular systemic manifestations, and examines the effects of the IL-6 receptor inhibitors sarilumab and tocilizumab on clinical endpoints of RA, patient-reported outcomes, and common comorbidities and extra-articular manifestations.

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High prevalence of comorbid autoimmune diseases in adults with type 1 diabetes from the HealthFacts database

Abstract: Additional autoimmunity represents a significant comorbidity in patients with T1D. Autoimmune diseases are more common in Caucasians and in women, and increase with age. Clinicians treating patients with T1D should be aware of the risk factors for additional autoimmune diseases.

Cited by 31 publications

References 33 publications

Sex Differences in Autoimmune Multimorbidity in Type 1 Diabetes Mellitus and the Risk of Cardiovascular and Renal Disease: A Longitudinal Study in the United States, 2001–2017

Sex Differences in Autoimmune Multimorbidity in Type 1 Diabetes Mellitus and the Risk of Cardiovascular and Renal Disease: A Longitudinal Study in the United States, 2001–2017

Celiac disease in children with type 1 diabetes varies around the world: An international, cross‐sectional study of 57 375 patients from the SWEET registry

Understanding the Role of Interleukin-6 (IL-6) in the Joint and Beyond: A Comprehensive Review of IL-6 Inhibition for the Management of Rheumatoid Arthritis

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