Autoimmune comorbidity in type 1 diabetes and its association with metabolic control and mortality risk in young people: a population-based study
Authors' conclusion
To our knowledge, this is the first comprehensive study where young individuals with type 1 diabetes were followed regarding development of a wide spectrum of autoimmune diseases, from onset of type 1 diabetes. In this nationwide and population-based study, there was already a high prevalence of autoimmune diseases in childhood, especially coeliac and thyroid disease. The presence of autoimmune comorbidity did not have a statistically significant effect on metabolic control or mortality risk.
Study context
- Population
- Children and young adults registered with T1D before 18 years of age between 2000 and 2019, Swedish National Diabetes Register; mean±SD age at onset 9.5±4.4 yearsmatched cohort
- Participants
- 15,188 vs 74,210
- Exposure
- T1D vs matched population controls
- T1Dn = 15,188
- Controln = 74,210reference
- Outcome
- Autoimmune comorbidity from T1D onset; association with HbA1c and mortality risk
- Follow-up
- Within 19 years from onset of T1D
Methodological detailsregister-based, nationwide, 5 matched controls per case, 346 individuals with T1D not found in Statistics Sweden register could not be matched
- Register-based
- Nationwide
- 5 matched controls per case
- 346 individuals with T1D not found in Statistics Sweden register could not be matched
Main finding
As reported in the abstract
Autoimmune comorbidity · within 19 years from T1D onset
T1D vs ControlHazard ratio (95% CI)
Coeliac disease
11.6(10.6–12.6)
Thyroid disease
10.6(9.6–11.8)
Psoriasis
1.3(1.1–1.6)
Vitiligo
4.1(3.2–5.3)
Rheumatic joint disease
1.7(1.4–2.2)
Inflammatory bowel disease
1.0(0.8–1.3)
Systemic connective tissue disorder
1.0(0.7–1.2)
Uveitis
1.4(1.1–1.9)
Addison's disease
18.3(8.4–40.0)
Multiple sclerosis
1.8(0.9–3.6)
Inflammatory liver disease
3.7(1.6–8.7)
Atrophic gastritis
19.6(4.2–92.3)
Observational data: associations, not effects.
Further findings
HbA1c and mortality risk with vs without autoimmune comorbidity in T1D
- Autoimmune disease in addition to T1D had no statistically significant effect on HbA1c or mortality risk
Original publication
Autoimmune comorbidity in type 1 diabetes and its association with metabolic control and mortality risk in young people: a population-based study. Diabetologia. Published 22 January 2024. doi:10.
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