In adults living with type 1 diabetes, additional autoimmune diseases are associated with more chronic complications and depression. A BETTER registry analysis.

IF 4.7
Cassandra A A Locatelli, Meryem K Talbo, Virginie Messier, Caroline Grou, Maha Lebbar, Erin E Mulvihill, Anne-Sophie Brazeau, Rémi Rabasa-Lhoret
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Abstract

Aim: People living with type 1 diabetes (T1D) are at elevated risk of additional autoimmune diseases (ADs) than the general population. We aimed to describe the association between additional ADs and T1D-related physical and mental burden in adults.

Methods: This was a cross-sectional analysis using data from the BEhaviors, Therapies, TEchnologies, and hypoglycemic Risk in T1D (BETTER) registry. Using patient reported-outcomes and validated questionnaires, we compared prevalence of vascular complications, hypoglycemia, and mental health issues between those with T1D alone (AD-) and T1D with additional AD (AD+).

Results: Among 3222 participants (66.2 % female, 42.7 ± 15.0 years), 36.3 % reported ≥ 1 AD+. The AD+ group was older (+4.4 years) and more female (+17.7 %) than the AD- group. The AD+ group had similar HbA1c (P = 0.20) but was more likely to report level 2 hypoglycemia in the past month (OR: 1.27 [95 %Cl 1.06-1.52]) and level 3 hypoglycemia since diagnosis (1.22 [1.05-1.42]). The AD+ group reported more cardiovascular disease (1.40 [1.03 to 1.90]), nephropathy (1.49 [1.19-1.86]), neuropathy (1.38 [1.13-1.69]), retinopathy (1.48 [1.22-1.78]), higher depression scores (p = 0.015), and anxiety/depression medication use (1.31 [1.10-1.56]). Number of AD+ was positively associated with depression scores (1 AD+ P = 0.055, 2+ AD+ p = 0.027), level 3 hypoglycemia since diagnosis (1 AD+ p = 0.037, 2+ AD+ P = 0.025), and number of chronic complications (1 AD+ P < 0.001, 2+ AD+ P < 0.001).

Conclusion: For people with T1D, living with additional ADs is associated with higher levels of physical and mental diabetes complications, warranting regular screening in this population.

在患有1型糖尿病的成年人中,额外的自身免疫性疾病与更多的慢性并发症和抑郁症相关。更好的注册表分析。
目的:1型糖尿病(T1D)患者患其他自身免疫性疾病(ADs)的风险高于一般人群。我们的目的是描述额外的ad与成人t1d相关的身体和精神负担之间的关系。方法:这是一项横断面分析,使用来自T1D患者的行为、治疗、技术和低血糖风险(BETTER)登记的数据。使用患者报告的结果和有效的问卷,我们比较了单独T1D (AD-)和T1D合并AD (AD+)患者血管并发症、低血糖和精神健康问题的患病率。结果:在3222名参与者中(66.2%为女性,42.7±15.0岁),36.3%报告≥1 AD+。AD+组比AD-组年龄大(+4.4岁),女性患者多(+ 17.7%)。AD+组HbA1c相似(P = 0.20),但在过去一个月内报告2级低血糖(OR: 1.27 [95% Cl 1.06-1.52])和诊断后报告3级低血糖(OR: 1.22[1.05-1.42])的可能性更大。AD+组出现更多心血管疾病(1.40[1.03 ~ 1.90])、肾病(1.49[1.19 ~ 1.86])、神经病变(1.38[1.13 ~ 1.69])、视网膜病变(1.48[1.22 ~ 1.78])、抑郁评分(p = 0.015)和焦虑/抑郁药物使用(1.31[1.10 ~ 1.56])。AD+次数与抑郁评分(1 AD+ P = 0.055, 2+ AD+ P = 0.027)、诊断以来3级低血糖(1 AD+ P = 0.037, 2+ AD+ P = 0.025)、慢性并发症次数(1 AD+ P < 0.001, 2+ AD+ P < 0.001)呈正相关。结论:对于T1D患者,患有额外ad的患者与更高水平的身体和精神糖尿病并发症相关,需要对该人群进行定期筛查。
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