A disease is characterized as autoimmune when, among other things:
• The disease is associated with genes that regulate the immune system
• The presence of autoantibodies and self-reacting T cells is involved in the pathogenesis
• The transport of T lymphocytes or antibodies reproduces the disease in previously healthy individuals.
“Autoimmune diseases start in early childhood, where almost 20% of people under the age of 6 already have diseases other than type 1 diabetes.”
SD.1 is often accompanied by other autoimmune diseases
Diabetes mellitus is a heterogeneous metabolic disorder characterized by a common feature of chronic hyperglycemia with a disturbance in the metabolism of carbohydrates, fats and proteins.
T lymphocyte-mediated autoimmune inflammation is the basis of type 1 diabetes, Rheumatoid Arthritis and Multiple Sclerosis.
The destruction of β cells caused by autoimmunity is the underlying cause of SD.1, while more subtle reductions in cell mass and functional damage are observed in SD.2.
B lymphocytes are involved in inflammation and are associated with insulin resistance, obesity and T2D. Diabetes mellitus includes a wide range of overlapping phenotypes. Newer theories attempt to bridge the gap between the two main types (SDt1 and SDt2).
At the crossroads between them, LADA (Latent Autoimmune Diabetes of the Adult) bridges the two types and sheds light on their pathogenesis.
• The term Latent Autoimmune Diabetes of the Adult (LADA) was introduced in 1995 to define the subgroup of adult patients with diabetes – clinically classified – with respect to people with SD.2, but tested positive for various islet autoantibodies. Five years after diagnosis, 80% of patients with LADA become insulin dependent.
The most common co-occurring organ-specific autoimmune disease in patients with SD.1 is autoimmune thyroid disease. Their incidence is estimated at> 90% among patients with SD.1 and other autoimmune diseases.
in conclusion
People with SD.1 should be screened for other autoimmune diseases – especially celiac disease, thyroid and rheumatoid arthritis.
Type 2 diabetes is in the process of being redefined as an autoimmune disease and not just a metabolic disorder, which could lead to new treatments for diabetes targeting the immune system instead of trying to control blood sugar.
If SD.2 is an autoimmune disease, the treatment strategy could be changed. The addition of immunomodulatory drugs to its treatment, which are widely used in the treatment of Autoimmune Diseases, could be considered.
Writes:
Mr. Eleni Komninou, Rheumatologist, Director of the Metropolitan General Autoimmune Rheumatic Diseases Clinic
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