White women at greatest risk of developing additional autoimmune conditions after type 1 diabetes

Posted on 16 November 2018

Hands together

Women and people of Caucasian ethnicity are much more likely to develop additional autoimmune conditions than other groups, following a diagnosis of type 1 diabetes.

These results come from a study that analysed the health records of over 150,000 adults with type 1 diabetes in the USA, to investigate the prevalence of additional autoimmune conditions.

Overall, 23% of adults with type 1 diabetes were found to have at least one additional autoimmune condition, with thyroid conditions the most common.

Sex, ethnicity and age all affected how likely a person with type 1 diabetes was to develop another autoimmune condition.

Why did they do this research?

There are over 80 known autoimmune conditions, in which the immune system accidentally attacks different parts of the body for reasons that are unclear.

We know that people who develop type 1 diabetes are at increased risk of developing additional autoimmune conditions. This is because autoimmune conditions have a number of overlapping features.

Researchers have previously studied additional autoimmune conditions in children with type 1 diabetes, but not much work has been carried out that focuses on adults or ethnic minorities.

The team therefore decided to look at additional autoimmune conditions in adults with type 1 diabetes, and across different ethnicities.

What did they find?

A fifth of adults with type 1 diabetes had autoimmune thyroid conditions, making them the most common additional conditions to develop. Rheumatoid arthritis and gastrointestinal diseases like coeliac disease were also common.

Overall, women were almost twice as likely to have additional autoimmune conditions compared with men.

Women were also more likely to have multiple additional autoimmune conditions, with 4% developing two and 1% developing three additional autoimmune conditions. This compares with 1.7% for two and 0.2% for three additional conditions in men.

The risk of developing an additional autoimmune condition also increased with age. Almost 40% of women and 25% of men over 80 years old had another autoimmune condition, compared with 18% of women and 9% of men under 30.

In terms of ethnicity, 26% of Caucasians had additional autoimmune conditions, compared with 20% of Asians, 18% of Hispanics, 15% of African Americans and 15% of Native Americans.

What does this mean for type 1?

These results add to a growing body of evidence that people who develop type 1 diabetes are at increased risk of additional autoimmune conditions, which can lead to complex health needs.

Yicheng Bao, who led the study, is a fourth year medical student at the University of Missouri-Kansas City. He highlighted the need for people to be aware that they may develop further autoimmune conditions:

“Implications for this study are that patients with type 1 diabetes should be vigilant for other autoimmune diseases as they age – Caucasian women are at particularly high risk.”

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