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Feature Article

Autoimmune conditions associated with type 1 diabetes

Pat Phillips, Jessica Phillips

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Abstract

People with type 1 diabetes are likely to have another autoimmune disease, and possibly more. The presence of these associated immune conditions should be sought, ideally at the time of diabetes diagnosis.

Key Points

  • Autoimmune thyroid disease is the most common autoimmune endocrine disease in patients with type 1 diabetes.
  • Coeliac disease affects about 5% of children with type 1 diabetes, and also occurs in adults.
  • Hypoadrenalism is the main feature of the more common form of polyglandular autoimmune syndrome associated with type 1 diabetes.
  • Unexpected hypoglycaemia in type 1 diabetes can be caused by undiagnosed hypothyroidism, coeliac disease, hypoadrenalism and, rarely, hypopituitarism.
  • Features of pregnancy care in women with type 1 diabetes include tight glycaemic control preconceptionally and during pregnancy, and management of coeliac disease and pregnancy-related changes in associated hypothyroidism if present.
  • Women with type 1 diabetes may develop more severe and/or additional autoimmune diseases after pregnancy.

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