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Diabetes Care. 2018 Oct 25. pii: dc181157. doi: 10.2337/dc18-1157. [Epub ahead of print]

Late-Onset T1DM and Older Age Predict Risk of Additional Autoimmune Disease.

Author information

1
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, MO jing.hughes@wustl.edu jmcgill@wustl.edu.
2
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, MO.
3
University of Missouri-Kansas City School of Medicine, Kansas City, MO.
4
Mercy Hospital Northwest Arkansas and University of Arkansas for Medical Sciences-Northwest Regional Campus, Fayetteville, AR.
5
Washington Regional Medical Center, Fayetteville, AR.
6
Gilead Sciences, Foster City, CA.
7
Northwell Health Lenox Hill Hospital, New York, NY.
8
Novant Health, Charlotte, NC.
9
Pritzker School of Medicine, The University of Chicago, Chicago, IL.
10
John Peter Smith Hospital, Fort Worth, TX.

Abstract

OBJECTIVE:

Type 1 diabetes (T1DM) is associated with other autoimmune diseases (AIDs), which may have serious health consequences. The epidemiology of AIDs in T1DM is not well defined in adults with T1DM. In this cross-sectional cohort study, we sought to characterize the incident ages and prevalence of AIDs in adults with T1DM across a wide age spectrum.

RESEARCH DESIGN AND METHODS:

A total of 1,212 adults seen at the Washington University Diabetes Center from 2011 to 2018 provided informed consent for the collection of their age, sex, race, and disease onset data. We performed paired association analyses based on age onset of T1DM. Multivariate logistic regression was used to evaluate the independent effects of sex, race, T1DM age of onset, and T1DM duration on the prevalence of an additional AID.

RESULTS:

Mean age of T1DM onset was 21.2 ± 14.4 years. AID incidence and prevalence increased with age. Female sex strongly predicted AID risk. The most prevalent T1DM-associated AIDs were thyroid disease, collagen vascular diseases, and pernicious anemia. T1DM age of onset and T1DM duration predicted AID risk. Patients with late-onset T1DM after 30 years of age had higher risks of developing additional AIDs compared with patients with younger T1DM onset.

CONCLUSIONS:

The prevalence of AIDs in patients with T1DM increases with age and female sex. Later onset of T1DM is an independent and significant risk factor for developing additional AIDs. Individuals who are diagnosed with T1DM at older ages, particularly women, should be monitored for other autoimmune conditions.

PMID:
30361208
PMCID:
PMC6300704
[Available on 2020-01-01]
DOI:
10.2337/dc18-1157

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