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Paediatrics: Type 1 diabetes mellitus - associated illnesses
Patients with T1DM are at increased risk for a number of other autoimmune disorders.
Type 1 diabetes mellitus: associated illnesses
Patients with T1DM are at increased risk for a number of other autoimmune disorders.
The most important of these are the following:
- Autoimmune thyroiditis: up to 5% develop hypothyroidism.
- Coeliac disease:
the prevalence rate of 5–10%;
usually atypical symptoms or asymptomatic.
- Adrenal insufficiency: uncommon.
Testing for thyroid autoantibodies, thyroid function tests (TSH and free T4), together with a coeliac disease antibody screen (transglutaminase or endomysial antibodies), should be carried out on an annual basis for the early detection and treatment of these disorders.
Screening and long-term monitoring
Glycaemic control
Glycated haemoglobin index (HbA1c) measured every 3–4mths.
Growth and development
- Height/weight/BMI (regularly at the clinic).
- Puberty stage (annual).
Microvascular complications
- Microalbuminuria screening:
urine dipstick test (regularly at the clinic);
3 early morning urinary albumin/creatinine ratio (annual screening).
- Retinopathy screening: retinal photography (annual screening).
- Neuropathy (rare).
- Associated autoimmune disease:
thyroid disease (annual);
coeliac disease (annual).