An Autoimmune Condition
There are many pointers to an immune-mediated basis for human type 1 diabetes. These include the association of type 1 diabetes with other autoimmune disorders and with the HLA system, which modulates immune responses; lymphocytic infiltration of the islets in post mortem human pancreas (insulitis); evidence of cell-mediated and humoral immunity directed against islet constituents; transfer experiments in animals, evidence of transmission of diabetes from marrow donors to recipients; recrudescence of autoimmunity in pancreatic grafts between identical twins; and preservation of beta cell mass and function by immune interventions. Evidence that type 1 diabetes is immune-mediated One of the earliest pointers to an autoimmune aetiology was the observation that other autoimmune conditions were over-represented in juvenile cases of diabetes and their relatives, but not in late-onset cases. Type 1 diabetes overlaps with autoimmune thyroid disease, coeliac disease, Addison’s disease and pernicious anaemia among other organ-specific autoimmune conditions (see Figure 1). Autoantibodies directed against islet constituents precede the onset of clinical disease by many years and can be used to predict it; they are present in 95% of newly presenting patients. Moreover, they are also more prevalent in first degree relatives of patients than in the general population (Figure 2). Several islet antigens have been characterised, and these include insulin itself, the enzyme glutamic acid decarboxylase (GAD), protein tyrosine phosphatase (IA-2) and the cation transporter ZnT8. Animal models of autoimmune diabetes such as the non-obese diabetic (NOD) mouse have been extensively studied. The observation that treatment with immunosuppressive agents such as ciclosporin prolongs beta cell sur Continue reading >>
Associated Autoimmune Diseases In Children And Adolescents With Type 1 Diabetes Mellitus
INTRODUCTION Type 1 diabetes mellitus (T1DM), one of the most common chronic diseases in childhood, is caused by insulin deficiency resulting from the destruction of insulin-producing pancreatic beta cells. (See "Pathogenesis of type 1 diabetes mellitus".) Children and adolescents with T1DM are at increased risk for developing other autoimmune diseases, most commonly autoimmune thyroiditis and celiac disease. These associated autoimmune diseases are presented here. Other issues in this population are discussed separately: (See "Epidemiology, presentation, and diagnosis of type 1 diabetes mellitus in children and adolescents".) Continue reading >>
- Are Obesity-Related Insulin Resistance and Type 2 Diabetes Autoimmune Diseases?
- Disparities in Diabetes Deaths Among Children and Adolescents United States, 20002014
- Relative contribution of type 1 and type 2 diabetes loci to the genetic etiology of adult-onset, non-insulin-requiring autoimmune diabetes
Type 1 Diabetes
Print Overview Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy. Different factors, including genetics and some viruses, may contribute to type 1 diabetes. Although type 1 diabetes usually appears during childhood or adolescence, it can develop in adults. Despite active research, type 1 diabetes has no cure. Treatment focuses on managing blood sugar levels with insulin, diet and lifestyle to prevent complications. Symptoms Type 1 diabetes signs and symptoms can appear relatively suddenly and may include: Increased thirst Frequent urination Bed-wetting in children who previously didn't wet the bed during the night Extreme hunger Unintended weight loss Irritability and other mood changes Fatigue and weakness Blurred vision When to see a doctor Consult your doctor if you notice any of the above signs and symptoms in you or your child. Causes The exact cause of type 1 diabetes is unknown. Usually, the body's own immune system — which normally fights harmful bacteria and viruses — mistakenly destroys the insulin-producing (islet, or islets of Langerhans) cells in the pancreas. Other possible causes include: Genetics Exposure to viruses and other environmental factors The role of insulin Once a significant number of islet cells are destroyed, you'll produce little or no insulin. Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas). The pancreas secretes insulin into the bloodstream. Insulin circulates, allowing sugar to enter your cells. Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secre Continue reading >>
Is Type 2 Diabetes An Autoimmune Disease?
Type 2 diabetes is in the process of being redefined as an autoimmune disease rather than just a metabolic disorder, said an author of a new study published in Nature Medicine this week, the findings of which may lead to new diabetes treatments that target the immune system instead of trying to control blood sugar. As part of the study the researchers showed that an antibody called anti-CD20, which targets and eliminates mature B cells in the immune system, stopped diabetes type 2 developing in lab mice prone to develop the disease, and restored their blood sugar level to normal. Anti-CD20, available in the US under the trade names Rituxan and MabThera, is already approved as a treatment for some autoimmune diseases and blood cancers in humans, but more research is needed to see if it will work against diabetes in humans. The researchers believe that insulin resistance, the hallmark of type 2 diabetes (unlike type 1 diabetes where it is the insulin-producing cells that are destroyed), is the result of B cells and other immune cells attacking the body's own tissues. Co-first author Daniel Winer, now an endocrine pathologist at the University Health Network of the University of Toronto in Ontario, Canada, started working on the study as a postdoctoral scholar at Stanford University School of Medicine in California, USA. He told the press that: "We are in the process of redefining one of the most common diseases in America as an autoimmune disease, rather than a purely metabolic disease." "This work will change the way people think about obesity, and will likely impact medicine for years to come as physicians begin to switch their focus to immune-modulating treatments for type-2 diabetes," he added. The discovery brings type 2 diabetes, until now considered to be more of a Continue reading >>
What Causes Autoimmune Diabetes?
Autoimmune diabetes is influenced by genetics. What starts the autoimmune destruction is unknown, but it may be due to environmental factors. You may want to learn more about how type 1a diabetes develops. We know type 1a diabetes is caused by an autoimmune process in the body that mistakenly destroys the insulin-producing cells, or beta cells and occurs in genetically predisposed individuals. What starts the autoimmune destruction is unknown, but it may be due to environmental factors. In this section, you can learn more about: What is the Immune system? An overview of the different cells and organs in the immune system and how the immune system works Autoimmunity and diabetes: Current ideas about how the immune systems destroys insulin producing cells Continue reading >>
What Is An Autoimmune Disease?
Tweet Autoimmune disease refers to illness or disorder that occurs when healthy tissue (cells) get destroyed by the body's own immune system. The term autoimmune disease is one that many people with diabetes - in particular, those with type 1 diabetes - will have come across or be familiar with. In the case of type 1 diabetes, the disease-fighting system mistakes healthy cells in the pancreas for foreign, harmful invaders and attacks them, leaving the body unable to produce its own insulin and keep levels of blood glucose under control. There are more than 80 different types of autoimmune disease, from multiple sclerosis and type 1 diabetes to coeliac disease and rheumatoid arthritis. The immune system is the body's protection against harmful substances such as bacteria, viruses and toxins, all of which contain harmful antigens. To counter this, the immune system produces and sends antibodies (special proteins) to identify destroy these antigens. However, in some cases the immune system cannot distinguish between healthy, harmless tissue and antigens and, as a result, it attacks and destroys normal tissue (in people with diabetes, the cells mistakenly targeted are the insulin-producing beta cells in the pancreas). This autoimmune reaction (or 'attack') is what triggers the development of an autoimmune disease. What causes the immune system to act this way? The exact cause of autoimmune disease is unknown, although there are many theories about what causes it to malfunction including: Bacteria or virus Drugs Chemical irritants Environmental irritants Studies have shown that autoimmune disorders often run in families and are much more common in women. How serious is it? As well as destroying body tissue, an autoimmune reaction can also affect organ function or result in t Continue reading >>
Type 1 Diabetes Causes
It isn’t entirely clear what triggers the development of type 1 diabetes. Researchers do know that genes play a role; there is an inherited susceptibility. However, something must set off the immune system, causing it to turn against itself and leading to the development of type 1 diabetes. Genes Play a Role in Type 1 Diabetes Some people cannot develop type 1 diabetes; that’s because they don’t have the genetic coding that researchers have linked to type 1 diabetes. Scientists have figured out that type 1 diabetes can develop in people who have a particular HLA complex. HLA stands for human leukocyte antigen, and antigens function is to trigger an immune response in the body. There are several HLA complexes that are associated with type 1 diabetes, and all of them are on chromosome 6. Different HLA complexes can lead to the development of other autoimmune disorders, such as rheumatoid arthritis, ankylosing spondylitis, or juvenile rheumatoid arthritis. Like those conditions, type 1 diabetes has to be triggered by something—usually a viral infection. What Can Trigger Type 1 Diabetes Here’s the whole process of what happens with a viral infection: When a virus invades the body, the immune system starts to produce antibodies that fight the infection. T cells are in charge of making the antibodies, and then they also help in fighting the virus. However, if the virus has some of the same antigens as the beta cells—the cells that make insulin in the pancreas—then the T cells can actually turn against the beta cells. The T cell products (antibodies) can destroy the beta cells, and once all the beta cells in your body have been destroyed, you can’t produce enough insulin. It takes a long time (usually several years) for the T cells to destroy the majority of th Continue reading >>
Type 2: Autoimmune?
Conventional wisdom holds that Type 1 diabetes is an autoimmune condition — caused by a misguided attack by the immune system on the beta cells of the pancreas — while Type 2 diabetes is not, caused instead by a combination of genes and lifestyle. Experts have debated the relative importance of genes, lifestyle, and environmental factors in the development of Type 2 diabetes — and at times, studies linking Type 2 diabetes to pollution and toxins have fueled speculation that autoimmunity plays a role in its development. But until this month, there was little conclusive evidence of an autoimmune role in Type 2 diabetes. That changed last week, with the release of a study that addressed the potential connection between autoimmunity and Type 2 diabetes head-on. Published on the Web site of the journal Nature Medicine, the study had two components: one in humans, and one in mice. As described in a HealthDay article, for the mouse experiment, researchers fed mice a high-fat diet that would be expected to induce insulin resistance, a hallmark of Type 2 diabetes in humans. After five weeks, they gave some of the mice a drug, known as anti-CD20, that suppresses the immune system by depleting a type of immune system cell known as B cells. In mice given the drug, there was no sign of insulin resistance, and blood glucose levels were normal. All of the other mice developed insulin resistance. This result suggests that in overweight mice — and, most likely, humans — an immune system attack on fat cells, instigated by B cells, leads to insulin resistance. Conducting a similar experiment in humans would be much more complicated, both pragmatically and ethically, since the drug anti-CD20 (known as rituximab when intended for humans) broadly suppresses the immune system, not j Continue reading >>
Type 1 Diabetes
Type 1 diabetes can occur at any age. It is most often diagnosed in children, adolescents, or young adults. Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy. With type 1 diabetes, beta cells produce little or no insulin. Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. This buildup of glucose in the blood is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 1 diabetes. The exact cause of type 1 diabetes is unknown. Most likely, it is an autoimmune disorder. This is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. With type 1 diabetes, an infection or another trigger causes the body to mistakenly attack the cells in the pancreas that make insulin. The tendency to develop autoimmune diseases, including type 1 diabetes, can be passed down through families. Continue reading >>
Diabetes Overview
Almost everyone knows someone who has diabetes. An estimated 23.6 million people in the United States -- 7.8 percent of the population -- have diabetes, a serious, lifelong condition. Of those, 17.9 million have been diagnosed, and about 5.7 million people have not yet been diagnosed. Each year, about 1.6 million people aged 20 or older are diagnosed with diabetes. Diabetes is a disorder of metabolism -- the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of sugar. The three main types of diabetes are Type 1 Diabetes Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body's system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live. At present, scientists do not know exactly wh Continue reading >>
Type 1 Diabetes And Autoimmunity
Go to: Type 1 Diabetes and Autoimmune Thyroid Disease It is well known that T1D is frequently associated with other organ-specific autoimmune diseases, including autoimmune thyroid disease (AITD), pernicious anemia, and idiopathic Addison’s disease (4). Table 1 summarizes the prevalence of organ-specific autoimmune disease complicating T1D in Japanese and Caucasoid patients (5). In Japanese patients with T1D, the most common coexisting organ-specific autoimmune disease is AITD (> 90%). The prevalence of anti-thyroid autoantibodies in children with T1D at disease onset is about 20%, and anti-thyroid autoantibodies are particularly common in girls. Furthermore, it is reported that the prevalence of anti-thyroid antibodies increases with increasing age and that the presence of anti-thyroid antibodies at diagnosis of T1D predicts the development of future thyroid disease (6). Patients with anti-thyroid antibodies are 18 times more likely to develop thyroid disease than patients without anti-thyroid antibodies (7) (Fig.1). Therefore, for early detection of AITD in children with T1D, Glastras et al. suggested measurement of anti-thyroid antibodies and TSH at T1D onset and in yearly intervals after the age of 12 yr. Furthermore, the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Clinical Guidelines recommend the screening of thyroid function by analyzing circulating TSH at the diagnosis of diabetes and, thereafter, every 2nd yr in asymptomatic individuals without goiter and more frequent if goiter is present. To characterize the T1D patients complicated with AITD (autoimmune polyendocrine syndrome type 3 variant, APS3v), we have analyzed the clinical characteristics of patients with APS3v who were consecutively diagnosed at Nagasaki University Continue reading >>
- Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study
- New type of diabetes discovered - Could YOU be showing symptoms of type 1.5 NOT type 2?
- Relative contribution of type 1 and type 2 diabetes loci to the genetic etiology of adult-onset, non-insulin-requiring autoimmune diabetes
People With Type 1 Diabetes Often Have Another Autoimmune Disease
It has been known that people with type 1 diabetes develop additional autoimmune diseases at higher rates but researchers looked to find out more details such as prevalence and additional factors in a recent study. According to Endocrine Today, a “diagnosis of at least one other autoimmune disease was found for 27% of participants; most had one additional diagnosis (20%) followed by 5% with two and less than 1% with three, four or five.” Janet B. McGill, MD, FACE, professor of medicine at the Washington University School of Medicine in St. Louis and Endocrine Today Editorial Board member and team used data they obtained from 25,759 participants with type 1 diabetes who were enrolled in the T1D Exchange Registry. They analyzed the types and frequency of autoimmune diseases in these participants including their relationships to gender, age, and race/ethnicity. Diagnosis of autoimmune diseases were obtained from medical records of the Exchange Registry participants. Who Develops Additional Autoimmune Diseases? Of all the T1D Exchange participants, half were female, 82 percent non-Hispanic white, with a mean age of 23 years and a mean duration of diabetes of 11 years. Endocrine Today reports that the mean A1c was 8.4 percent. Of these participants 6,876 or 27 percent were diagnosed with at least one autoimmune disease on top of the type 1 diabetes. The frequency of 2 or more autoimmune diseases went up from 4.3 percent in participants under age 13 to 10.4 percent in those 50 or older. Which Autoimmune Diseases are Most Common? The most common autoimmune disease for the participants were thyroid related at 6,097 or 24 percent. The next most common were gastrointestinal at 1,530 or 6 percent and collagen vascular diseases at 432 or 2 percent. The researchers stated that A Continue reading >>
Type 1 Diabetes Often Comes With Other Autoimmune Diseases
(Reuters Health) - People with type 1 diabetes often develop other autoimmune disorders, such as thyroid and gastrointestinal diseases, and a recent study yields new information about this link. In type 1 diabetes, the immune system attacks the pancreas and destroys its insulin-producing cells. Patients often develop other immune system diseases, too. Indeed, in the current study, 27 percent of patients had at least one other autoimmune disorder. But the new study also held some surprises about how early and late in life these added health problems might surface, said lead author Dr. Jing Hughes of Washington University School of Medicine in St. Louis. “The pattern that emerged was striking: autoimmune diseases begin early in childhood, where nearly 20 percent of those under age 6 already have additional diseases other than type 1 diabetes,” Hughes said by email. “Another surprise finding was that, while we had expected that autoimmune diseases may peak at a certain time of life, we found instead that the autoimmune burden continues to increase as patients age, to the extent that nearly 50 percent of those over age 65 have accumulated one or more additional autoimmune disease,” Hughes added. The findings are drawn from data on nearly 26,000 adults and children being treated for type 1 diabetes at 80 endocrinology practices in the U.S. between 2010 and 2016. Of those with other autoimmune disorders in addition to diabetes, 20 percent had one additional problem and 5 percent had at least two additional diseases, researchers report in the Journal of Clinical Endocrinology and Metabolism. Participants with one or more additional autoimmune disorders were more likely to be older, female and white, the study found. They also tended to have been diagnosed with type 1 d Continue reading >>
- Are Obesity-Related Insulin Resistance and Type 2 Diabetes Autoimmune Diseases?
- Powerful new cancer drugs are saving lives, but can also ignite diabetes or other autoimmune conditions
- Relative contribution of type 1 and type 2 diabetes loci to the genetic etiology of adult-onset, non-insulin-requiring autoimmune diabetes
Type 2 Diabetes: Is It An Autoimmune Disease?
For decades, doctors and researchers have believed type 2 diabetes is a metabolic disorder. This type of disorder occurs when your body’s natural chemical processes don’t work properly. New research suggests type 2 diabetes may actually be an autoimmune disease. If that’s the case, new treatments and preventive measures may be developed to treat this condition. Currently, there isn’t enough evidence to fully support this idea. For now, doctors will continue to prevent and treat type 2 diabetes with diet, lifestyle changes, medications, and injected insulin. Read on to learn more about the research that’s being done and the implications it may have on the treatment and prevention of type 2 diabetes. Type 2 diabetes has historically been viewed as a different type of disease from type 1 diabetes, despite their similar name. Type 2 diabetes occurs when your body becomes resistant to insulin or can’t produce enough insulin. Insulin is a hormone that moves glucose from your blood to your cells. Your cells convert glucose to energy. Without insulin, your cells can’t use glucose, and symptoms of diabetes can occur. These symptoms may include fatigue, increased hunger, increased thirst, and blurred vision. Type 1 diabetes, sometimes called juvenile diabetes because it’s often diagnosed in children and teens, is an autoimmune disease. In people with type 1 diabetes, the immune system mistakenly attacks the healthy tissues of the body and destroys the insulin-producing cells of the pancreas. The damage from these attacks prevents the pancreas from supplying insulin to the body. Without an adequate supply of insulin, cells can’t get the energy they need. Blood sugar levels rise, leading to symptoms such as frequent urination, increased thirst, and irritability. E Continue reading >>
Other Diseases That Are More Common In People With Type 1 Diabetes
Other Diseases That Are More Common in People With Type 1 Diabetes KidsHealth / For Parents / Other Diseases That Are More Common in People With Type 1 Diabetes Kids and teens with type 1 diabetes have a greater risk for other health problems, many of which also are autoimmune disorders. The diabeteshealth care team will watch kids for signs of these problems. But parents also should know what to look for so that they can alert doctors and get treatment, if necessary. In autoimmune disorders, the immune system attacks the body's healthy tissues as though they were foreign invaders. A severe attack can affect how that body part works. Type 1 diabetes is an autoimmune disease. The pancreas can't make insulin because the immune system attacks it and destroys the cells that produce insulin. Kids and teens with type 1 diabetes are at risk for other autoimmune problems, but these aren't actually caused by the diabetes. Doctors still aren't exactly sure why autoimmune diseases happen. But genetics probably play an important role because relatives of people with type 1 diabetes are more likely to have autoimmune diseases. Most kids with type 1 diabetes never need treatment for any other autoimmune disorder. But those who do might develop: These disorders can develop before a child is diagnosed with type 1 diabetes or months or years after the diabetes diagnosis. Kids and teens with type 1 diabetes are more likely to get disorders affecting the thyroid. The thyroid, which is part of the endocrine system , makes hormones that help control metabolism and growth. These hormones play a role in bone development, puberty, and many other body functions. Thyroid disease is fairly common in people with type 1 diabetes, affecting 15% to 20% of them. In thyroid disease, the thyroid gland Continue reading >>
