ESPE Abstracts

Introduction: Autoimmune thyroid diseases (ATD) are the most common autoimmune disorders associated with type 1 diabetes (T1D). Most patients present hypothyroidism. Although hyperthyroidism is less frequent, severe forms of thyrotoxicosis coexisting with diabetic ketoacidosis (DK) have been described in children with either preexisting diabetes, thyroid disease, or both. Celiac disease (CD) incidence is higher and ranges from 0.6-16.4%.

Objetive: To evaluate the prevalence of autoimmune diseases in children and adolescents with T1D and its increase in recent years.

Methods: We studied 365 children (F:181,M:184) with T1D followed-up at our center between June 2007 and June 2022, with a median age at diabetic debut of 9.39 (6.46;11.29) years.

Statistical analysis: R version 4.2.2. Fisher's test exact was used to compare qualitative data.

Results: ATD was found in 119 patients (F:81,M:38). The prevalence was 32.6 %. Thirty two (F:23,M:9) children presented hypothyroidism (26.8%), 84 (F:57,M:27) had euthyroidism (69.7%). Four patients (F:2,M:2) presented hyperthyroidism (3.36%), one of them before, one simultaneously with diabetes onset, and the others at follow-up. Both children with hyperthyroidism at diabetic debut developed severe thyrotoxicosis coexisting with DK and requiring prolonged intensive care. All cases of hyperthyroidism were diagnosed in the last five years. Time between T1D onset and ATD was 0.95 (0; 2.37) years. There were 31 patients who had euthyroidism and in the follow up developed hypothyroidism in a median period of 0,94 (0.54;2.32) years. Thirty Three (F:18, M:15) patients had CD. Prevalence was 9 %. Median age at CD diagnosis was 10 years (6.8;11.6), and time between T1D onset and CD was 0.24 (0;0.87) years. ATD prevalence was compared between the last five years period and the previous 10 years. In the last 5 years (n:83) was 40,7% and in previous period was 22% (n:36) (P<0,001). Significant statistics differences were not found in CD prevalence between the two periods.

Conclusion: These patients with T1D showed a high prevalence of ATD and CD, similar to that previously reported. ATD prevalence seems to be increasing in recet years. These results emphasize the need of monitoring thyroid function and celiac disease in children and adolescents with T1D.