Celiac and Thyroid Diseases Linked to Over Twofold Higher Risk of Type 1 Diabetes, Especially in Youth: Study Finds

The retrospective, observational study analyzed real-world insurance claims data to assess the incidence of new-onset type 1 diabetes among individuals with celiac disease, hyperthyroidism (such as Graves' disease), and hypothyroidism (such as Hashimoto’s thyroiditis), compared with matched individuals who had none of these autoimmune conditions. The research team used a 1:1 propensity score matching strategy to ensure similar baseline characteristics between groups, allowing for a more accurate comparison of diabetes risk.

The study led to the following findings:

• During a median follow-up of two years, individuals with celiac disease, hyperthyroidism, or hypothyroidism were found to be significantly more likely to develop type 1 diabetes compared to those without these conditions.
• In the celiac disease group, 0.14% (68 out of 47,099) developed T1D compared to 0.06% (27 out of 47,099) in the control group.
• Among individuals with hyperthyroidism, 0.17% (281 out of 164,830) developed T1D, while only 0.06% (99 out of 164,830) of their matched counterparts did.
• In the hypothyroidism cohort, 0.18% (1,756 out of 980,477) developed T1D, versus 0.08% (764 out of 980,477) in controls.
• The risk of developing type 1 diabetes was more than double in all three disease groups compared to controls, with hazard ratios of 2.54 for celiac disease, 2.98 for hyperthyroidism, and 2.41 for hypothyroidism.
• The risk of T1D was especially elevated among individuals younger than 18 years.
• The time to T1D diagnosis was shorter in individuals with autoimmune diseases than in those without, suggesting a faster progression toward clinical diabetes in these groups.

The researchers suggest that individuals with celiac disease or thyroid disorders could benefit from regular screening for type 1 diabetes, particularly for markers like islet autoantibodies that can indicate the presence of stage 2 T1D before clinical symptoms appear. Early detection could allow timely interventions, including disease-modifying therapies, potentially preventing or delaying the onset of overt diabetes and its complications.

These findings reinforce the interconnectivity of autoimmune conditions and highlight the need for integrated care approaches. The authors advocate for increased vigilance and screening protocols to identify at-risk individuals early, offering a window of opportunity for preventive strategies.

Reference:

Edelman SV, Agardh D, Cui N, Hao L, Wieloch M, Meneghini L. Risk of new-onset type 1 diabetes in individuals with celiac disease and thyroid disease-An observational study. Diabetes Obes Metab. 2025 May 28. doi: 10.1111/dom.16454. Epub ahead of print. PMID: 40437819.