For patients living with type 1 diabetes (T1D), instances of additional autoimmune diseases (ADs) are frequent and significantly impact mental and physical health burdens, according to a study published in Diabetes & Metabolism.1 Researchers’ findings showed a heightened need for additional mental and physical health support among the T1D population.
“T1D is an AD that results in the destruction of insulin producing beta cells in the pancreas,” wrote the authors of the study. “It is well established that ADs tend to co-occur; around 1 in 4 adults with T1D live with one or more other ADs and adolescents with T1D have nearly 5-fold higher rates of AD than those without T1D diagnosis.”
Before the onset of additional ADs, people with T1D already live difficult lives because of the various responsibilities they need to manage to control their disease. According to the Mayo Clinic, the treatment regimen for T1D typically includes 5 actions: taking insulin; counting carbohydrates, fats, and protein; monitoring blood sugar often; eating healthy foods; and exercising regularly and keeping a healthy weight.2
Of the total study population, 36.3% had additional ADs, with autoimmune thyroid diseases (hypo and hyperthyroidism) being the most prevalent. | image credit: Alina / stock.adobe.com
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As authors of the current study mentioned, both adults and children with T1D are significantly more susceptible to additional ADs when compared with other populations.1 According to a study in the Journal of Personalized Medicine, researchers previously uncovered associations between T1D and ADs affecting the endocrine, digestive, skin, and musculoskeletal systems. Some of those specific diseases include celiac disease, autoimmune gastritis, rheumatoid arthritis, and many more.3
“Despite the frequency of co-occurrence of T1D with additional AD, the literature remains scarce on the association of multiple ADs with diabetes-related complications, as well as mental health complications, but even more on the impact of living with other ADs on T1D management,” continued the authors.1 “Thus, our aim is to complement the current literature by investigating the associations of the presence of one or more additional AD with diabetes management, the presence of acute and chronic T1D complications, and mental health indicators in Canadian adults living with T1D.”
Conducting a cross-sectional analysis of Canadians with T1D, researchers gathered data from the Behaviors, Therapies, Technologies, and Hypoglycemic Risk in T1D (BETTER) registry in Canada. This data included questionnaire responses from Canadian adults 18 or older between April 2019 and March 2024. To be included in the study, participants answered questions on ADs and took insulin. Over 20 diseases were included as additional ADs among patients with T1D, such as ulcerative colitis, Crohn disease, alopecia areata, and Guillain-Barre syndrome, among many others.
The analysis featured a total of 3222 participants (66.2% women; mean age, 42.7 years old) with T1D. Of the total study population, 36.3% had additional ADs, with autoimmune thyroid diseases (hypo- and hyperthyroidism) being the most prevalent among all ADs uncovered (25.8%). Celiac disease was the next most prominent at 6.4% of those having an additional AD, followed by inflammatory joint diseases like rheumatoid arthritis and psoriasis.
Aside from the ADs associated with patients having T1D, those who reported any additional AD also had higher risks of CVD, nephropathy, neuropathy, and retinopathy. The presence of any additional AD was also associated with high cholesterol. Finally, researchers discovered that patients with T1D and an additional AD were taking more depression or anxiety medications than their counterparts without additional AD.
“Living with T1D and one or more AD+ is frequent, and this co-occurrence is associated with higher rates of level 2 and 3 hypoglycemia, long-term complications, as well as depression and anxiety medication use,” they wrote.1 “This indicates a need for additional mental and physical health support for this population with T1D.”
Throughout the researchers’ cross-sectional analysis, they uncovered several results mirroring previous studies on the association between T1D and additional AD risk.
From common risk factors among the T1D population to the physical and mental burdens the disease presents, results of the study further highlighted the greater need for personalized care among patients with T1D. Researchers suggested further attention on disease screening in this population going forward, with costs as well as physical and mental burdens in mind.
“In light of the present findings, screening for ADs may be justified in attempts to prevent the negative associations discussed herein,” concluded the authors.1 “Optimal timing and diseases to be screened will need additional research to ensure a positive cost-benefit of these procedures.”
READ MORE: Diabetes Resource Center
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