Tip 1 Diyabette Otoimmün Komorbiditeler ve Metabolik Sonuçlar: Retrospektif Kesitsel Bir Çalışma

Öz

Amaç: Tip 1 diyabetes mellitus (T1DM), sıklıkla otoimmün hastalıklarla birlikte görülen kronik bir metabolik bozukluktur. Bu çalışmanın amacı, özellikle çölyak hastalığı başta olmak üzere, T1DM’ye eşlik eden otoimmün hastalıkların metabolik kontrol ve diyabetik komplikasyonlar üzerindeki etkisini araştırmaktır. Gereç ve Yöntem: Bu retrospektif kesitsel çalışmada, T1DM’li hastalar arasında otoimmün hastalıkların prevalansı değerlendirildi. Çölyak hastalığı veya Hashimoto hipotiroidisi bulunan T1DM’li hastalarda metabolik regülasyon ve diyabetik komplikasyonlar, yalnızca T1DM’si olan hastalarla karşılaştırıldı. Bulgular: Toplam 155 T1DM’li hastanın %26.5’inde Hashimoto’ya bağlı otoantikor pozitifliği (n = 41), %7.7’sinde çölyakla ilişkili otoantikor pozitifliği (n = 12) ve %1.9’unda Graves’le ilişkili otoantikor pozitifliği (n = 3) saptandı. Çölyak otoantikorları pozitif olan semptomatik üç hastaya endoskopik duodenum biyopsisi yapıldı ve bir hastada çölyak hastalığı ile uyumlu histopatolojik bulgular tespit edildi. Sekiz seropozitif hasta biyopsiyi reddetti, ancak glutensiz diyet başlandıktan sonra semptomları geriledi. Otoimmün komorbiditesi olan ve olmayan hastalar arasında metabolik kontrol veya diyabetik komplikasyonlar açısından anlamlı bir fark saptanmadı (p > 0.05). Sonuç: Otoimmün hastalıklar, genel popülasyona kıyasla T1DM’li bireylerde daha sık görülmesine rağmen, glisemik regülasyon üzerinde anlamlı bir etkide bulunmamaktadır. Bununla birlikte, yaşam kalitesini artırmak ve komorbiditelerin yükünü azaltmak amacıyla rutin tarama önerilmektedir.

Anahtar Kelimeler

• Otoimmün hastalıklar
• çölyak hastalığı
• diyabet komplikasyonları
• glutensiz diyet
• hipotiroidizm

Autoimmune Comorbidities and Metabolic Outcomes in Type 1 Diabetes: A Retrospective Cross-Sectional Study

Öz

Objective: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder frequently accompanied by autoimmune diseases. This study aimed to investigate the impact of coexisting autoimmune disorders, particularly celiac disease, on metabolic control and diabetic complications in patients with T1DM. Material and Methods: This retrospective cross-sectional study evaluated the prevalence of autoimmune diseases among patients with T1DM. Metabolic regulation and diabetic complications in patients with T1DM who also had celiac disease or Hashimoto’s hypothyroidism were compared with those in patients with T1DM alone. Results: Among 155 patients with T1DM, 26.5% had Hashimoto-related autoantibody positivity (n = 41), 7.7% had celiac-related autoantibody positivity (n = 12), and 1.9% had Graves-related autoantibody positivity (n = 3). Endoscopic duodenal biopsy was performed in three symptomatic patients with positive celiac autoantibodies, and histopathological findings consistent with celiac disease were identified in one patient. Eight seropositive patients declined biopsy but became asymptomatic after starting a gluten-free diet. No significant differences in metabolic control or diabetic complications were observed between patients with or without autoimmune comorbidities (p > 0.05). Conclusion: Although autoimmune disorders are more prevalent in individuals with T1DM than in the general population, they do not appear to influence glycemic regulation meaningfully. Nonetheless, routine screening remains advisable to enhance quality of life and reduce the burden of comorbidities.

Anahtar Kelimeler

• Autoimmune diseases
• celiac disease
• diabetes complications
• gluten-free diet
• hypothyroidism

Kaynakça

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