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Horm Metab Res 2018; 50(07): 568-574
DOI: 10.1055/a-0631-2468
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Diabetes Mellitus and Autoimmune Hepatitis: Demographical and Clinical Description of a Relatively Rare Phenotype

Gideon de Sousa
1   Children’s Hospital Dortmund, Dortmund, Germany
2   Department of Pediatrics, University of Witten/Herdecke, Witten, Germany
,
Nicole Prinz
3   Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany
4   German Center for Diabetes Research (DZD), Munich-Neuherberg, Munich, Germany
,
Marianne Becker
5   Children’s Hospital, Helios Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
,
Renate Dürr
6   Children’s Hospital Rems-Murr, Winnenden, Germany
,
Uta Faller
7   Children’s Hospital, Oberschwabenklinik, Ravensburg, Germany
,
Dagmar Meraner
8   Department of Pediatrics and Adolescent Medicine, University Innsbruck, Innsbruck, Austria
,
Nicolai Heise
9   Department of Internal Medicine, Helfenstein Klinik, Geislingen/Steige, Germany
,
Illa Engelmann
10   Department of Internal Medicine, Medius Kliniken, Nürtingen, Germany
,
Herbert Bruckmayer
11   Department of Internal Medicine, Hospital Ruhpolding, Ruhpolding, Germany
,
Dagobert Wiemann
12   Department of Pediatrics, University of Magdeburg, Magdeburg, Germany
,
Maria Fritsch
13   Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria
,
Bernd Stratmann
14   Diabeteszentrum, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
,
Reinhard W. Holl
3   Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany
4   German Center for Diabetes Research (DZD), Munich-Neuherberg, Munich, Germany
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Publikationsverlauf

received 25. Februar 2018

accepted 08. Mai 2018

Publikationsdatum:
10. Juli 2018 (online)

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Abstract

We studied demographic, metabolic, and clinical characteristics of patients with diabetes and autoimmune hepatitis (AIH) from the German/Austrian DPV registry. A total of 139 patients with diabetes and AIH were analyzed and compared to 437 728 patients with diabetes without AIH. The prevalence of AIH in patients with T1DM (44.8/100 000) seems higher than in the general population, the prevalence of AIH in patients with T2DM (23.6/100 000) does not seem to be increased. Patients with T2DM and AIH had a shorter duration of diabetes (p=0.007) and a higher proportion of females (p<0.001) compared to T2DM without AIH. Patients with diabetes (T1DM or T2DM) and AIH required higher insulin doses (p<0.001 and p=0.03, respectively) and showed increased liver enzymes (aspartate transaminase, alanine transaminase, gamma-glutamyltransferase) compared to diabetes patients without (all p<0.001). We detected a lower percentage of patients treated with oral antidiabetic drugs (p=0.01) and a higher percentage of patients treated by insulin in patients with T2DM and AIH (p<0.001) compared to patients with T2DM alone. We observed a higher incidence of autoimmune thyroid disease (AIT) in patients with diabetes (T1DM or T2DM) and AIH (p<0.001) compared to diabetes patients without AIH. AIH seems more frequent in patients with T1DM. Patients with diabetes and AIH require intensification of antidiabetic therapy and seem to have a higher prevalence of AIT.

Key words

type 1 diabetes - type 2 diabetes - autoimmune thyroid disease - clinical outcome - diabetes treatment
 

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