The Effect of Associated Autoimmune Disease on Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus

Diabetes mellitus type 1(T1DM) is one of the most common chronic diseases in childhood, is caused by insulin deficiency resulting from the destruction of insulin-producing pancreatic beta cells.

Children and adolescents with T1DM are at increased risk for developing other autoimmune diseases( autoimmune thyroid disease, coeliac disease, Addison disease, AIJ, psoriazis, vitiligo, etc). This could have an effect on the metabolic control of diabetes in the long term The detection of conccurent autoimmune disease is important to prevent morbidity related to unrecognized disease.

Objective: The aim of this study is to asses the prevalence of different types of autoimmune disorders in a group of children with diabetes mellitus type 1 (T1DM) and to evaluate the effect of conccurent autoimmune condition (AI) on glycaemic control and growth.

Methods: A retrospective cross-sectional study was conducted on 152 patients with T1DM, aged between 1 and 18 years, who were followed up at the Second Pediatric Clinic Cluj-Napoca, from January 2011 to May 2016. The medical records and laboratory findings in the hospital’s electronic system of all patients were reviewed.

Results: The prevalence of associated autoimmunity was 26.97% in our population. Out of the 41 patients, 27 (17.6%) had autoimmune thyroid disease, 9 (5,92%) had coeliac disease, and 3(1,97) had juvenile arthritis, 1(0,65%) had psoriazis and 1(0,65%) had vitiligo. Addison’s disease was not diagnosed in this cohort of patients. There was no significant difference either in growth parameters or HbA1c between children with associated autoimmune disease and T1DM compared with children with T1DM.

Conclusions: The prevalance of conccurent autoimmune disease is greater in children with T1DM than in general population. The effect of having another concomitant autoimmune condition on metabolic control of diabetes and growth is not clear.