Having an autoimmune disease is linked to increased risk of LADA

Autoimmune diseases (ADs) tend to cluster, with individuals who have one AD being more prone to others due to genetic and environmental factors. Conditions like thyroid dysfunction and coeliac disease are common in childhood-onset type 1 diabetes, but less is known about AD clustering in adults with autoimmune diabetes.

Researchers from the Institute of Environmental Medicine, Karolinska Institutet used data from the ESTRID study nested within the ANDIS biobank and incidence register covering the Swedish region of Scania. They analysed data from over 5,000 participants, including newly diagnosed LADA cases (n=586), type 2 diabetes patients (n=2003), and matched controls (n=2355), examining links between 33 autoimmune diseases and diabetes outcomes.

The study revealed that individuals with autoimmune conditions were 70% more likely to develop LADA. Specific autoimmune diseases, such as thyroid dysfunction, inflammatory bowel disease, and vitiligo, were notably associated with higher LADA risk (OR: 1.88, 1.78, and 3.91). This association was stronger for individuals with elevated autoantibodies. In contrast, only psoriasis showed a significant association with type 2 diabetes.

Researchers also explored shared biological pathways between ADs and LADA, identifying immune response mechanisms, including innate and adaptive immunity, as potential drivers of these associations. Interestingly, while LADA patients with ADs had an elevated risk of diabetic retinopathy compared to type 2 diabetes patients, having an AD did not independently increase the risk of retinopathy within the LADA group.

The findings underscore the importance of monitoring autoimmune disease comorbidity in patients at risk for LADA, with implications for improved diabetes management and patient outcomes.

First author of the study is Cornelia Santoso, post doctoral researcher in the ESTRID group.

Publication

Autoimmune diseases and the risk and prognosis of latent autoimmune diabetes in adults.
Santoso C, Wei Y, Ahlqvist E, Tuomi T, Carlsson S
Diabetologia 2024 Oct;():