Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine

Abstract

Type 1 Diabetes Mellitus (T1DM) is a common hyperglycemic disease characterized by the autoimmune destruction of insulin-producing beta cells of the pancreas. Various attempts have been made to understand the complex interplay of genetic and environmental factors which lead to the development of the autoimmune response in an individual. T1DM is frequently associated with other autoimmune illnesses, the most common being autoimmune thyroid disorders affecting more than 90% of people with T1D and autoimmune disorders. Antithyroid antibodies are present in around 20% of children with T1D at the start of the illness and are more frequent in girls. Patients with T1DM often have various other co-existing multi-system autoimmune disorders including but not limited to thyroid diseases, parathyroid diseases, celiac disease, vitiligo, gastritis, skin diseases, and rheumatic diseases. It is a consistent observation in clinics that T1DM patients have other autoimmune disorders which in turn affect their prognosis. Concomitant autoimmune illness might affect diabetes care and manifest itself clinically in a variety of ways. A thorough understanding of the complex pathogenesis of this modern-day epidemic and its association with other autoimmune disorders has been attempted in this review in order to delineate the measures to prevent the development of these conditions and limit the morbidity of the afflicted individuals as well. The measures including antibody screening in susceptible individuals, early identification and management of other autoimmune disorders, and adoption of personalized medicine can significantly enhance the quality of life of these patients. Personalized medicine has recently gained favor in the scientific, medical, and public domains, and is frequently heralded as the future paradigm of healthcare delivery. With the evolution of the ‘omics’, the individualization of therapy is not only closer to reality but also the need of the hour.

Unveiling the Link: A Comprehensive Narrative Review of the Relationship Between Type 1 Diabetes Mellitus and Celiac Disease

“…The primary gene for susceptibility is found on chromosome 6's HLA region, and it has a high association with alleles DR3, DR4, DQA1-0501, DQA1-0201, DQA1-0301, and DQB1-0302. The HLA complex is thought to be responsible for 40-50% of T1DM risk [2]. HLA-linked T1DM causes increasing insulin insufficiency and hyperglycemia.…”

“…The autoimmune process that is growing in pancreatic beta cells can also impact other organs, which leads to the emergence of autoimmune disorders that are specific to those organs, or it can damage a variety of non-specific tissues and organs, resulting in autoimmune diseases that are not particular to those organs [20]. Anti-islet autoantibodies arise before the clinical disease emerges, and T1DM is usually accompanied by some autoimmune diseases [2].…”

“…Since diabetes is an autoimmune condition, it is seen to impact other organs, which can result in making the management more difficult to overcome [2]. T1DM is accompanied by several autoimmune disorders: Hashimoto's thyroiditis, Graves' disease, Addison's disease, celiac disease (CD), and autoimmune gastritis [3][4][5][6][7].…”

“…An autoimmune reaction directed against pancreatic beta cells characterizes T1DM, also an autoimmune condition. Anti-islet autoantibodies arise before the clinical need emerges, and T1DM is usually accompanied by other autoimmune diseases [2]. This article focuses on the association between T1DM and CD, its pathophysiology, association, serodiagnosis, and management.…”

Type 1 diabetes and the risk of epilepsy: A meta‐analysis

“…Patients with type 1 diabetes exhibit a range of clinically established complications that can be attributed to impaired glucose metabolism, namely retinopathy, nephropathy, peripheral neuropathy, and cardiovascular disease 6,7 . Furthermore, type 1 diabetes has been associated with various immune disorders, including coeliac disease, hypothyroidism, hyperthyroidism, and Addison disease 8 . Notably, recent research indicates a potential heightened susceptibility among patients with type 1 diabetes to several neurocognitive disorders 9,10 , including epilepsy 11 .…”