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People with diabetes—especially those with type 1 diabetes (T1DM)—are more likely to develop other autoimmune and immunological disorders. This clustering of conditions is not coincidental.
It reflects:
Shared genetic susceptibility (e.g. HLA-DR3, DR4, DQ2, DQ8)
Common immune system pathways (e.g. T-cell dysregulation, autoantibodies)
Environmental and epigenetic triggers (e.g. viral infections, diet, gut microbiome)
Although type 2 diabetes (T2DM) is not autoimmune, it involves chronic inflammation and insulin resistance, which have their own immunological implications—particularly an association with increased risk of certain cancers and altered immune responses.
| Condition | Key Features | Screening/Notes |
|---|---|---|
| Autoimmune Thyroid Disease | Hashimoto’s (↓ thyroid), Graves’ (↑ thyroid) Common in T1DM (~30%) | TSH, anti-TPO Ab Monitor thyroid function regularly |
| Coeliac Disease | GI symptoms, anaemia, poor growth (children) Can be asymptomatic | tTG-IgA + total IgA Strong link with T1DM (5–10%) |
| Addison’s Disease | Fatigue, ↓ BP, weight loss, pigmentation Recurrent hypos, postural symptoms | Morning cortisol, ACTH, adrenal Abs Consider if unexplained symptoms |
| Pernicious Anaemia | B12 deficiency → macrocytic anaemia, glossitis, neuropathy | B12, anti-parietal cell & IF Abs Screen if symptomatic or anaemia present |
| Other Autoimmune Conditions | Vitiligo – depigmented patches RA, SLE – less common but possible | Clinical exam ± relevant Abs Monitor symptoms |
| Malignancy in T2DM | ↑... |
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