Diabetes Mellitus in Adult Patients with Type 1 Diabetes Shows
Immunological, Functional and Clinical Differences Depending on the Presence of Autoimmune
Thyroiditis
Vondra K., Bendlová B., Šterzl I., Vrbíková J., Zamrazil V.
Endokrinologický ústav, Praha 1 |
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Summary:
Background. Autoimmune diabetes is usually accompanied by other autoimmune endocrinopathies,
most often by autoimmune thyroiditis (AIT), but it is not clear whether diabetes in these patients differs
from diabetes without AIT.
Methods and Results. Eleven-year follow-up of 47 young adult Type 1 diabetic patients with respect to
the presence of AIT (group I – positive antibodies against microsomal peroxidase, antiTPO, and
tyreoglobulin, antiTgl, group II – only positive antiTPO, group III – without AIT) showed:
a) cessation of endogenous insulin secretion (Cpeptide <0.03 nmol/l) in 100 % of patients with AIT
(in group I between year 2 and 9, in group II between year 3 and 11, p<0.05), while in group III without
AIT only in 55 % of patients (I,II vs. III, p<0.001);
b) higher prevalence of antiGAD values > 5 U/ml in group I when compared to patients without AIT
(I vs III, p<0.05);
c) tendency toward higher doses of insulin needed for diabetes compensation in patients without AIT;
d) the highest prevalence of organ-specific and systemic autoantibodies in group I with the most distinct
manifestations of AIT, and the lowest prevalence in group III without AIT (statistically significant).
Conclusions. Autoimmune diabetes in adults with AIT compared to diabetes occurring isolated showed
differences in the area of autoimmunity against islets of Langerhans, Langerhans islets’ function and in
the clinical course of the disease.
Key words:
diabetes mellitus Type 1, autoimmune thyroiditis, antiGAD, antiIA2, Langerhans islets’
function, autoimmune polyglandular syndromes.
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