Type 1 Diabetes With Other Autoimmune Diseases

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Editor’s Note: This content has been verified by Marina Basina, MD, a Clinical Associate Professor at Stanford University. She’s a clinical endocrinologist and researcher with a focus on diabetes management and diabetes technology. Dr. Basina is an active member of multiple medical advisory boards and community diabetes organizations, and she is on the Beyond Type 1 Science Advisory Council. 


People with Type 1 diabetes, an autoimmune disease, are more likely to have a co-occurring autoimmune disorder. An autoimmune disease means that your immune system sees your body’s own tissue as foreign invaders and attacks itself. For example, if you have Type 1, your body mistakenly attacks the insulin-producing (beta) cells in your body. The reason that co-occurring autoimmune disorders are so common isn’t exactly known, although we do know that genetics play a significant role.

Because we know that having Type 1 puts you at a higher risk of developing other autoimmune diseases, it’s important to be aware of what the signs and symptoms are. The following are warning signs that are common for all autoimmune diseases, including Type 1:

  • Fever
  • Fatigue
  • Rashes
  • Achiness
  • Weight loss
  • Concentration issues
  • Numbness/tingling in extremities
  • Insomnia
  • Abnormal heart rate
  • Fertility problems
  • Abdominal pain

These symptoms are non-specific and don’t necessarily indicate another autoimmune disease. However, you should see your doctor if you are exhibiting them.

Although the exact reason is unknown, there are a few autoimmune diseases that tend to co-occur with Type 1 diabetes that are listed below.

Celiac disease

10% of the population with Type 1 diabetes also have celiac disease. Celiac disease is an autoimmune disease in which suffers are unable to eat gluten because it causes their body’s immune system to attack its own small intestine. If someone with celiac is undiagnosed and continues to eat gluten on a regular basis, the small intestine becomes unable to properly absorb nutrients.

A few of the common symptoms specific to celiac disease are abdominal pain, diarrhea or constipation, delayed growth in children, canker sores, difficulties with fertility, and weight loss. There is no cure for celiac disease, however, avoiding gluten will stop the autoimmune attack.

Thyroid diseases

As much as 30% of the Type 1 diabetes population also has a thyroid disease, the most common of which are Hashimoto’s and Graves disease. In both of these diseases, the autoimmune system attacks the thyroid gland which regulates metabolism. This can lead to either an under-active or an overactive thyroid, respectively.

Hashimoto’s is an autoimmune condition that predisposes individuals to develop hypothyroidism, and symptoms include weight gain, cold sensitivity, slow heartbeat and constipation. For Graves disease, symptoms are weight loss, heat intolerance, quick heartbeat, and diarrhea. The treatment for Hashimoto’s involves taking oral hormone replacement, and for Graves disease, can involve medication, radioiodine therapy, or the removal of the thyroid.

Autoimmune gastritis

Up to 10% of the population with Type 1 diabetes has Autoimmune Gastritis as a co-occuring autoimmune disorder. Also known as Type A Gastritis, it is an autoimmune disease in which the stomach deteriorates because of an immune system attacks the healthy cells of the stomach lining. It can lead to anemia. The main symptom of gastritis is abdominal pain, and some of the symptoms of the resulting anemia are weakness, trouble concentrating, heart palpitations, and paleness. There is no treatment for autoimmune gastritis, however, anemia can be treated with iron and/or B12 supplements.

Multiple Sclerosis

Multiple Sclerosis (MS) is a rare autoimmune disease in which the immune system attacks the myelin sheath, which is a part of the nerve cells in the brain and spinal cord. It affects those with Type 1 diabetes over than 3 times more than those without T1D. Some of the symptoms of MS are fatigue, cognitive difficulties, weakness, and vision problems. Early signs of optic necrosis is blurry vision, pain when moving eyes, numbness, and facial pain. There is no known cure of MS, but there are disease-modifying drugs that do slow the progression of MS in some cases.  

Addison’s disease

Addison’s disease is caused by an autoimmune attack of the adrenal glands and results these glands inability to produce sufficient cortisol and sometimes aldosterone. Although it is not as common as the other autoimmune diseases listed above, the chances of getting diagnosed with Addison’s disease are significantly higher if you are already diagnosed with Type 1 diabetes. Some of the tell-tale symptoms of Addison’s are salt cravings, weight loss, hyper-pigmentation and sharp abdominal pain. The treatment of Addison’s disease is bi-daily oral hormone pills.

Lupus

Lupus is an autoimmune disease which affects the tissues in many different parts of the body. Most commonly, skin is affected in the form of sun-sensitive rashes, but blood vessels, joints, organs, and other areas can be impacted. Some common signs of lupus are a butterfly shaped rash on the face, fatigue, photosensitivity, anemia, and kidney complications are especially common in those who also have Type 1 diabetes. Since there is no cure for lupus, the treatment for lupus depends on the specific symptoms people are experiencing, but medications are common.

Vitiligo

Vitiligo is also thought to be a rare autoimmune disease that those with Type 1 diabetes are at a higher risk for. For those with vitiligo, the immune system attack skin cells called melanocytes, which affect skin pigmentation and therefore those with vitiligo have patches of discolored, lightened skin. Although there is no known cure for vitiligo, there are multiple different types of medication, therapies and surgeries that are targeted at restoring discolored skin.

Autoimmune arthritis

Although there are over 100 different types of arthritis and related diseases, the most common type is rheumatoid arthritis (RA), which is an autoimmune disease that results in the degradation of joint tissue. This leads to joint pain, swelling, and loss of function. If caught early, RA can be treated aggressively with medication that may lead to remission of symptoms, although this is often not the case because RA is usually not caught until symptoms are severe.  There are different methods of treating RA, although they could be complicated by diabetes management, such as steroids that raise blood sugar.

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