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Patients with autoimmune diseases, including psoriasis, are at higher risk for being diagnosed with latent autoimmune diabetes in adults, or LADA.
At the Fall Clinical Dermatology Conference 2024, presentations on psoriasis discussed new treatment options, the impact of comorbidities, and advancing patient-centered care.
A separate study unrelated to the meeting that was published in Diabetologia focused on the risk for one of these comorbidities— latent autoimmune diabetes in adults (LADA)—among patients with autoimmune conditions, including psoriasis.
“The aim of this study was to clarify the impact of autoimmune disease comorbidity on the risk and prognosis of LADA,” Sofia Carlsson, PhD, and colleagues wrote.
Dr. Carlsson and colleagues examined data from three groups: people with newly diagnosed LADA (n=586) who were stratified into LADAlow and LADAhigh according to autoantibody levels; patients with type 2 diabetes (T2D; n=2,003) and matched controls (n=2,355). They collected information on 33 autoimmune diseases and diabetic retinopathy. The researchers then estimated ORs for LADA and type 2 diabetes in relation to autoimmune diseases before diabetes diagnosis and HRs for diabetic retinopathy after diabetes diagnosis.
Psoriasis Seen in Nearly 10% of LADA & T2D Cases
Compared with participants in the control group and patients with LADA, patients with T2D were older, more often women, and had a higher BMI. However, a family history of an autoimmune disease was higher among participants in the control group (50.2%) and patients with LADA (54.8%) than patients with T2D (45.4%).
Specifically, rates of any concomitant autoimmune disease were 21.7% in the control group, 33.8% in patients with LADA, and 25.8% in patients with T2D. Thyroid dysfunction was the most prevalent autoimmune disease, followed by psoriasis and rheumatoid arthritis.
Rates of psoriasis were 8.6% in T2D, 7.5% in LADA, and 5.6% in controls.
“There was an association between the number of [autoimmune diseases] and type 2 diabetes (OR, 1.17; 95% CI, 1.03-1.34), which was driven by the excess risk conferred by psoriasis (OR, 1.47; 95% CI, 1.08-1.99),” Dr. Carlsson and colleagues wrote.
However, once psoriasis was omitted, autoimmune diseases were not associated with T2D.
The Extensive Impact of Diabetes in Psoriasis
The findings suggest that several autoimmune diseases, including psoriasis, confer an increased risk for LADA, according to the researchers. They also noted that this study is—to their knowledge—the largest yet to examine autoimmune disease comorbidities in LADA and the first to evaluate LADA prognosis in relation to these diseases.
Dr. Carlsson and colleagues’ findings add to the growing knowledge base around psoriasis and diabetes. Another recent study on this topic indicated that insulin resistance might influence the efficacy of psoriasis treatment in patients with both conditions.
Further, psoriasis may influence the trajectory of diabetes in patients with both conditions. Findings published in the American Journal of Ophthalmology demonstrated that psoriasis was an independent risk factor for developing neovascular age-related macular degeneration in patients with diabetes.
With the findings from Dr. Carlsson and colleagues, clinicians should also now “be aware of the potential for LADA” in patients with autoimmune diseases, including the need for glutamic acid decarboxylase antibodies screening in those with newly diagnosed diabetes.
