Adolescents with Autoimmune Diseases Face Higher Risk of Type 1 Diabetes in Adulthood: Study Shows
Israel: A large-scale study published in Diabetes Care has shown that adolescents with autoimmune conditions face a significantly higher risk of developing type 1 diabetes (T1D) in adulthood.
The study analyzed data from over 1.4 million Israeli adolescents aged 16–19 and found that autoimmune diseases, particularly autoimmune thyroid disease (AITD) and celiac disease, were strong predictors of future T1D. Adolescents with any autoimmune condition had more than double the risk of developing T1D compared with their peers, highlighting the importance of long-term monitoring of glycemic health in this population.
The study, led by Dr. Gilad Twig from the Division of Endocrinology, Diabetes, and Metabolism at Sheba Medical Center, Ramat Gan, Israel, examined the association between autoimmune diseases and incident T1D, a link previously mostly studied among individuals who already had diabetes. Researchers included all adolescents without a history of dysglycemia who underwent medical evaluation before mandatory military service between 1996 and 2016. Data were then linked to the Israeli National Diabetes Registry to identify cases of adult-onset T1D.
Key Findings:
- The study included 1,426,362 adolescents, of whom 38,766 (2.7%) had a history of autoimmune disease at baseline.
- Among those with autoimmune diseases, 10,333 had autoimmune thyroid disease (AITD) and 9,603 had celiac disease.
- Over 15,810,751 person-years of follow-up, 37 cases of T1D occurred among adolescents with autoimmune diseases, compared to 740 cases among those without.
- The crude incidence rate of T1D was 9.6 cases per 100,000 person-years for adolescents with autoimmunity and 4.8 per 100,000 for those without.
- Adolescents with any autoimmune disease had a hazard ratio (HR) of 2.19 for developing T1D compared with those without autoimmune conditions.
- Adolescents with AITD had a fourfold increased risk of T1D (HR 3.99).
- Adolescents with celiac disease had nearly triple the risk of developing T1D (HR 2.82).
- The increased risk remained consistent when T1D cases were defined using mandatory islet-autoantibody data, confirming the robustness of the findings.
The study emphasizes that autoimmune conditions in late adolescence are associated with an increased likelihood of developing T1D in adulthood for both sexes. Researchers suggest that these findings should inform clinical practice by encouraging long-term glycemic monitoring in adolescents diagnosed with autoimmune disorders, particularly AITD and celiac disease. Early identification of at-risk individuals may allow for timely interventions and better management strategies to prevent or delay the onset of T1D.
"The study adds to growing evidence that autoimmune diseases in adolescence are not isolated conditions but may signal heightened vulnerability to T1D later in life. Healthcare providers are urged to consider autoimmune history as a key factor in risk assessment and follow-up planning for young adults," the authors concluded.
Reference:
Gilad Twig, Maya Simchoni, Inbal Dym, Adi Vinograd, Cole D. Bendor, Aya Bardugo, Avishai M. Tsur, Inbar Zucker, Miri Lutski, Estela Derazne, Cheli Cohen-Melzer, Gabriel Chodick, Arnon Afek, Hertzel C. Gerstein, Orit Pinhas-Hamiel, Amir Tirosh; Thyroid, Celiac, and Other Autoimmune Diseases and the Risk of Incident Type 1 Diabetes in Young Adulthood. Diabetes Care 2025; dc251423. https://doi.org/10.2337/dc25-1423
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