Introduction and Objective: People living with type 1 diabetes (pwT1D) are at risk for micro and macrovascular complications, mental health issues, as well as higher risk for additional autoimmune diseases (AD+). We aimed to understand the association between additional ADs and T1D related physical and mental burdens in Canadian adults.Methods: This was a cross-sectional study using data from the BEhaviors, Therapies, TEchnologies, and hypoglycemic Risk in T1D (BETTER) registry of adults (≥18 years) living with T1D. We compared reported prevalence of micro and macrovascular complications, hypoglycemia, and mental health questionnaire (PHQ-9 and DDS) scores between those with T1D alone and T1D with AD+.Results: Our study included 3222 participants (66.2% female, age 42.7 +/-15.0 years); 36.3% of respondents reported ≥1 additional AD and this AD+ group was older (+4.4 years) with a higher percentage of females (77.5%). pwT1D from AD+ group had similar HbA1c (p=0.20) but were more likely to report hypoglycemia: level 2 in the past month (OR: 1.27 [95%Cl 1.06-1.52]) and level 3 hypoglycemia (1.22 [1.05-1.42]) since diagnosis. The presence of additional ADs was associated with more chronic complications (cardiovascular disease, retinopathy, neuropathy, nephropathy, gastroparesis) (1.38-1.49), higher depression scores (p=0.015) and anxiety/depression medication use (1.31 [1.10-1.56]). However, there was no effect on diabetes distress score (DDS) (p=0.14). Higher number of ADs was associated with higher depression scores (p=0.03) and higher number of chronic complications (p<0.0001).Conclusion: Having additional ADs with T1D is associated with higher levels of both physical and mental complications of T1D.
C.A.A. Locatelli: None. M.K. Talbo: Other Relationship; Dexcom, Inc. V. Messier: None. R.P.R. Rabasa-Lhoret: Advisory Panel; Abbott, Eli Lilly and Company, Novo Nordisk, Sanofi, Insulet Corporation. Other Relationship; Medtronic. Advisory Panel; Bayer Pharmaceuticals, Inc.
The BETTER registry is supported by grants from the Canadian Institutes of Health Research (grant number JT1- 157204); Breakthrough T1D Canada (grant number 3- SRA-2024-1523-M-N); and Diabète Québec as well as through non-restrictive grants from Eli Lilly Canada Inc., Novo Nordisk Canada and Sanofi-Aventis Canada and a donation from Dexcom Canada.
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