Type (I) D.M. and Its Relation to Celiac Disease and Autoimmune Thyroid Disease
In type (I) D.M., the coexistence of other endocrine diseases and organ specific autoantibodies has been frequently reported, leading to the concept of autoimmune polyendocrine syndrome.
There is ample and convincing evidence for the autoimmune pathogenesis of type (I) D.M., e.g. inflammatory infiltration of the pancreas with T lymphocytes (insulitis), association with other autoimmune disorders, antibodies (ICA, IAA, GAD), and changes in cellular immunity.
The prevalence of celiac disease in patients with type (I) D.M. is approximately 20-fold that in the general population.
IgA antibodies against tissue transglutaminase were found in 1.0 – 6.5 % of patients with type (I) D.M. In 60 % of cases they are already present at the onset of diabetes (mostly undetected), whereas 40 % of patients develop celiac disease a few years after diabetes onset
The concurrence of type (I) D.M. and celiac disease may be explained by a similar genetic background associated with HLA DQ2 or 8, and similar trigger mechanisms for autoimmune process. More than 90 % of celiac disease patients and about 70 % of diabetics carry the HLA heterodimer DQA1*05DQb1*0201.
It's recommended that, in an active case finding strategy, the recent onset type (I) diabetic patients be routinely screened at least for concomitant autoimmune thyroid disease and for celiac disease (especially asymptomatic celiac disease).
Now in Saridar Lab, D.M. Screening, Autoimmune Thyroid Screening and Anti-Tissue Transglutaminase Antibodies (IgA & IgG) are done and the run out time is only 72 hours.