4.2.0.0 Au­toim­mune Dis­eases

Peo­ple with type 1 di­a­betes are at in­creased risk for other au­toim­mune dis­eases in­clud­ing thy­roid dis­ease, pri­ma­ry adrenal insufficien­cy, celi­ac dis­ease, au­toim­mune gas­tri­tis, au­toim­mune hep­ati­tis, der­mato­myosi­tis, and myas­the­nia gravis (25–27). Type 1 di­a­betes may also occur with other au­toim­mune dis­eases in the con­text of specific ge­net­ic disor­ders or polyg­lan­du­lar au­toim­mune syn­dromes (28). In au­toim­mune dis­eases, the im­mune sys­tem fails to main­tain self-‍tol­er­ance to specific pep­tides with­in tar­get or­gans. It is like­ly that many fac­tors trig­ger au­toim­mune dis­ease; how­ev­er, com­mon trig­gering fac­tors are known for only some au­toim­mune con­di­tions (i.e., gliadin pep­tides in celi­ac dis­ease) (see Sec­tion 13 “Chil­dren and Ado­les­cents”).