People with type 1 diabetes (T1D) often develop other autoimmune diseases, but the frequency and predictive factors for development have not been characterised.

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While the mechanisms for T1D are still under investigation, it is thought there are common immune system pathways that may be similar across more than one, or all autoimmune diseases. 

A new study published in The Journal of Clinical Endocrinology and Metabolism, aimed to detect prevalence of autoimmune diseases in over 25,000 participants in the T1D Exchange registry, an initiative supported by JDRF. They found that 27% of people with T1D had at least one additional autoimmune disease, and 5% of these had two other autoimmune diseases. These participants were aged 1-93 years old with a balanced gender split, from 80 endocrinology practices across the US. These findings are important as undetected autoimmune disease can impair growth and development, affect T1D management or in some cases can be life threatening.

This study also showed that people with one or more autoimmune disease were more likely to be older, female, and Caucasian. They were also more likely to be diagnosed later in life, and have a longer T1D duration. The most common other autoimmune disease was autoimmune thyroid disease, which was found in 24% of participants, followed by coeliac disease in 6% of participants.

The take home message is that people with T1D are an increased risk of developing other autoimmune diseases compared to people without T1D, particularly for females, Caucasians and older individuals. This is important as it has implications for screening in primary care clinics. Clinicians should be vigilant in screening for other common autoimmune diseases to identify silent developing autoimmunity before symptoms appear. Autoimmune thyroid disease and coeliac disease were the two most common and so should be given priority for screening, with other autoimmune diseases to be screened based on reported symptoms and family history. Screening for autoimmune thyroid and coeliac disease is already integrated into clinical practice guidelines in Australia and this study reiterates the importance of following these screening recommendations to ensure best patient care and outcomes.

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