A Study of Autoimmune Polyglandular Syndrome (APS) in Patients with Type1 Diabetes Mellitus Followed up at A Teritiary Care Hospital

Shaikh, Shaheen; Haji, Ismail M; Doddamani, Parveen; Rahman, Md. Habibur

doi:10.7860/jcdr/2014/7013.4011

Cited by 9 publications

(12 citation statements)

References 9 publications

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“…The frequency of occurrence of these diseases is increased in children and adolescents with T1DM in comparison to healthy children [ 20 , 21 ]. These diseases are associated with the presence of specific autoantibodies in blood serum, which can be detected prior to the development of clinically overt disease [ 20 – 22 ]. There are ongoing investigations of the genetic basis of the coincidence of T1DM and other autoimmune diseases.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents

Krzewska

Beń‐Skowronek

2016

BioMed Research International

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Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases developing in childhood. The incidence of the disease in children increases for unknown reasons at a rate from 3 to 5% every year worldwide. The background of T1DM is associated with the autoimmune process of pancreatic beta cell destruction, which leads to absolute insulin deficiency and organ damage. Complex interactions between environmental and genetic factors contribute to the development of T1DM in genetically predisposed patients. The T1DM-inducing autoimmune process can also affect other organs, resulting in development of additional autoimmune diseases in the patient, thereby impeding diabetes control. The most common T1DM comorbidities include autoimmune thyroid diseases, celiac disease, and autoimmune gastritis; additionally, diabetes can be a component of PAS (Polyglandular Autoimmune Syndrome). The aim of this review is to assess the prevalence of T1DM-associated autoimmune diseases in children and adolescents and their impact on the course of T1DM. We also present suggestions concerning screening tests.

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Section: Introductionmentioning

confidence: 99%

“…The results are described in Table 1 [ 23 ]. The occurrence of other autoimmune diseases in patients with type 1 diabetes deteriorates the quality of life and increases morbidity and mortality [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents

Krzewska

Beń‐Skowronek

2016

BioMed Research International

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“…The coexistence of and relationship between TD and DM have been addressed by many researchers (Wu, 2000;Betterle and Zanchetta, 2003;Betterle et al, 2004;Barker et al, 2005;Blois et al, 2010;Hage et al, 2011;Shaikh et al, 2014). The effects of these concurrent conditions on different systems of the body have been discussed only as retrospective studies on the basis of some naturally occurring clinical case records in humans, but the data were found lacking in the context of research trials into such a syndrome and its effects on reproductive health.…”

Section: Introductionmentioning

confidence: 99%

Effects of concomitant diabetes mellitus and hyperthyroidism on testicular and epididymal histoarchitecture and steroidogenesis in male animals

Korejo

Wei

Shah

2016

J. Zhejiang Univ. Sci. B

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This study evaluated the effects of comorbid disorders of diabetes and hyperthyroidism in the adult male mice. In total, 32 ICR strain mice were equally distributed into four groups: control (C), diabetic (D), diabetic-plushyperthyroid (DH), and hyperthyroid (H). Mice allocated for diabetes received a single intraperitoneal injection of streptozotocin (STZ) at 200 mg/kg body weight. At the onset of diabetes, one group of mice was concomitantly injected levothyroxine (LT4; 0.3 mg/kg body weight) and the other set of animals received the same treatment independently on a daily basis. The body weight, as well as the testicular and epididymal weights, was reduced markedly in D and DH mice. Higher trends of blood glucose levels were seen in the DH group, in comparison to euthyroid diabetic mice. Thyroid hormones could exert a transient effect on blood glucose homeostasis by altering the serum blood glucose level in diabetic patients. Histomorphometric analysis showed increased luminal sizes of seminiferous tubules, along with decreased epithelial height and atrophic changes in germinal stem cells in the testis of DH and H mice. Caput epididymis of DH mice showed extensive compaction of principal cells, loss of stereocilia, lipid vacuolization, and inflammatory infiltrations; however, damaged tubular integrity, packed clear cells, exfoliated cells, and round spermatids were profoundly noticed in the cauda epididymis. Hyperthyroidism elevated the serum testosterone levels in H and DH mice and produced critical damages to the histoarchitecture of the epididymis. Collectively, this experiment endeavored to mimic the polyglandular autoimmune syndrome, which will be helpful to better understand the reasons for male infertility in diabetic-cum-hyperthyroid patients.

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“…The effect of hypothyroidism on increasing insulin resistance and glucose metabolism is well documented 17 as thyroid hormones stimulate glucose uptake into peripheral tissues and enhance the effect of insulin action on glucose transport in to cell. 4,17 In hypothyroid patients this mechanism is disrupted leading to higher glucose levels leading to various acute and chronic complications of diabetes. 5 The strength of our study is the proper documentation of a large number of T1D subjects, however limitation of our study is that this is a single center study and antibody status was not checked in every subject due to financial constraints.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, genetic factors have also been postulated to be involved in the development of T1D and studies have shown that the development of T1D also increases the risk of development of other autoimmune diseases. The most frequent comorbid conditions in T1D include auto immune thyroid diseases [4][5][6][7][8] cardiac diseases (4-9%) pernicious anemia (5-10%), Addison's' disease (0.5%) and vitiligo (2-10%). 4,5 https://doi.org/10.1016/j.cegh.2019.01.001 Received 9 May 2018; Received in revised form 27 November 2018; Accepted 1 January 2019 Autoimmune thyroid diseases (ATD) are the most common autoimmune manifestations in children and adolescents with T1D 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Thyroid dysfunction in subjects with type 1 diabetes at a tertiary care unit of Karachi, Pakistan

Sajid

Riaz

Fawwad

et al. 2019

Clinical Epidemiology and Global Health

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Background: Genetic factors are involved in the development of T1D and studies have shown that the development of T1D also increases the risk of development of other autoimmune diseases. Objective: To assess the frequency of thyroid dysfunction in subjects with type 1 diabetes. Methodology: This study was conducted at Baqai Institute of Diabetology and Endocrinology (BIDE), a tertiary care diabetes center of Karachi Pakistan from January 2005 to March 2017. Subject with type 1 diabetes (T1D) of all ages and both genders were included in the study. T1D was diagnosed on the basis of History, physical examination and relevant laboratory tests. The data of all registered patients was entered in a specially designed software. Thyroid stimulating hormone (TSH) was used as a screening test to assess thyroid dysfunction in subjects with type 1 diabetes. Further evaluation included FT4, T3 and thyroid antibodies where indicated. The data was analyzed on SPSS version 20. Results: A total of 153 T1D subjects (67 male and 86 female) were included in the study. Out of 153 subjects, 23 (15.0%) had thyroid dysfunction of which 17 (11.1%) were found to have hypothyroidism (subclinical or clinical), 6 (3.9%) were hyperthyroid while 130(84.96%) subjects were having normal thyroid function. Statistical differences were found in body mass index and serum creatinine level among the different categories of thyroid dysfunction. The required dose of insulin was higher (but not significant) in subjects having hypothyroidism as compared to hyperthyroid or subjects with normal thyroid function. Conclusion: High frequency of thyroid dysfunction was observed in subjects with T1D. Hypothyroidism was more common than hyperthyroidism. All subjects with T1D should be screened with TSH to evaluate for thyroid dysfunction.

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A Study of Autoimmune Polyglandular Syndrome (APS) in Patients with Type1 Diabetes Mellitus Followed up at A Teritiary Care Hospital

Cited by 9 publications

References 9 publications

Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents

Effect of Associated Autoimmune Diseases on Type 1 Diabetes Mellitus Incidence and Metabolic Control in Children and Adolescents

Effects of concomitant diabetes mellitus and hyperthyroidism on testicular and epididymal histoarchitecture and steroidogenesis in male animals

Thyroid dysfunction in subjects with type 1 diabetes at a tertiary care unit of Karachi, Pakistan

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