PhD Scientific Days 2025

Conservative Medicine I.

Treatment Strategies in Type 1 Diabetes Mellitus and Autoimmune Polyglandular Syndrome – A Comparative Analysis Across Age Groups

Name of the presenter

Kiss Boglárka

Institute/workplace of the presenter

Internal Medicine and Hematology Clinic

Authors

Boglárka Kiss¹

1: Internal Medicine and Hematology Clinic

Text of the abstract

Introduction:
Type 1 diabetes mellitus (T1DM) is usually associated with other organ-specific autoimmune diseases, collectively referred to as autoimmune polyglandular syndromes (APS).
Aims:
Our objective was to assess the prevalence of autoimmune comorbidities in T1DM patients, analyze insulin dosage, delivery methods, sensor use, and HbA1c levels in different age groups. The study utilized patient data from the Pediatric, Internal Medicine, and Hematology Clinics of the University.
Methods:
A total of 1053 patients were included and categorized into the following age groups: 4–10; 11–14; 15–18; 19–30; 31+. We analyzed data from 709 children (mean age 13 ± 3.9 years) and 344 adults (mean age 29 ± 14.6 years). Normality of distribution was assessed, and comparisons were performed using Student's t-test.
Results:
APS prevalence was 22% in children and 15.4% in adults. The most common APS in children was celiac disease (66%), while in adults it was autoimmune thyroiditis (57%). HbA1c values were significantly better in the 4–10-year-old group compared to all other groups, highlighting the impact of parental control. Prepubertal children (11–14 years) also showed significantly lower HbA1c compared to the 15–18 and 19–30 age groups, likely due to hormonal and lifestyle changes.
In the 4–10 group (n=184), 62 (33.7%) had APS, mean insulin dose was 15.9 ± 6.6 U, and HbA1c was 7.3 ± 1%.
In the 11–14 group (n=218), 72 (33%) had APS, insulin dose was 34.7 ± 17.3 U, HbA1c was 7.5 ± 1.4%.
In the 15–18 group (n=307), 89 (29%) had APS, insulin dose was 50 ± 22.4 U, HbA1c was 7.9 ± 1.8%.
In the 19–30 group (n=239), 75 (31.4%) had APS, insulin dose was 55.3 ± 20.8 U, HbA1c was 8.1 ± 1.6%.
In the 31+ group (n=105), 16 (15.2%) had APS, insulin dose was 54 ± 38 U, HbA1c was 8 ± 2%.
Conclusion:
Age-specific treatment strategies are essential in T1DM, with insulin pump and sensor technologies offering strong support. The frequent coexistence of organ-specific autoimmune diseases significantly affects patients’ lifestyle and quality of life. Our findings underscore the importance of regular screening for autoimmune comorbidities in T1DM care.
Funding:
This research was supported by the University Research Scholarship Program of the Ministry of Culture and Innovation (grant number 2024-2.1.1-EKÖP-2024-00004), funded by the National Research, Development and Innovation Fund.