Paediatrics: Type 1 diabetes mellitus: associated illnesses

Type 1 diabetes mellitus: associated illnesses

Patients with T1DM are at increased risk for a number of other autoim-mune disorders.

The most important of these are the following:

·Autoimmune thyroiditis: up to 5% develop hypothyroidism.

·Coeliac disease:

      prevalence rate 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 clinic).

·Puberty stage (annual).

Microvascular complications

·Microalbuminuria screening:

      urine dipstick test (regularly at 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).