Diabetes and Risk of MS

Bechtold S, Blaschek A, Raile K, Dost A, Freiberg C, Askenas M, Fröhlich-Reiterer E, Molz E, Holl RW.Higher Relative Risk for Multiple Sclerosis in a Pediatric and Adolescent Diabetes Population: Analysis From DPV Data Base. Diabetes Care. 2013 Aug. [Epub ahead of print]

Objective: Type 1 diabetes and multiple sclerosis (MS) are typical autoimmune diseases in children and young adults. We assessed the co-occurrence of type 1 diabetes and MS by estimating the relative risk for MS in a paediatric and adolescent diabetes population and looked for possible influencing factors.
Research Design Data of 56,653 patients with type 1 diabetes were collected in 248 centers in Germany and Austria. Published data on German and Mid-European MS prevalence were taken for comparison. Multivariable regression analysis was used to identify confounders for co-occurrence of type 1 diabetes and MS.
Results Relative risk for MS in type 1 diabetes was estimated at 3.35 to 4.79 (95% CI: 1.56 to 7.21 and 2.01 to 11.39, respectively). As influencing factors on MS incidence could be identified immigration status in all (p<0.05) and thyroid antibodies in males only (p= 0.05). The month of birth pattern was higher during the spring and summer months in the type 1 diabetes with MS in comparison to the type 1 diabetes population.
ConclusionThe present cohort study demonstrates a higher risk of co-occurrence of MS in a pediatric and adolescent diabetes population. Immigration status and thyroid antibodies in males were independent risk indicators for incidental rate of MS. Diabetic patients born during spring and summer had a higher risk to develop MS. We suggest that environmental factors modulate the individual’s risk for the co-occurrence of both diseases

At the week end we were talking about Sardinia, where there is a higher risk of MS and type 1 diabetes (a disease of the beta cells that produce insulin in the pancreas) than in the rest of Italy. In this study from Germany/Austria in diabetes, which is more typical a juvenile onset compared to many autoimmune diseases that is more common in adults. They found that that there is 3 times the risk of MS in diabetics compared to the general population. If we look at the genetics of diabetes and MS there are common genes that are associated with both Ms and diabetes the only difference needs to be with target the immune system gets directed towards. 

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  • When I was first diagnosed, I refused steroids as I believed it could bring on Diabetes. This was prior to the Internet and DMTs. I knew there was a family history of diabetes, my Great-great grandmother and some of her children. The diabetes has died out, but I have MS. Interesting.

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