- Type 1 diabetes doesn’t always travel solo – people with type 1 diabetes can be more susceptible to other autoimmune conditions. The most common ones associated with T1D are thyroid disease and celiac disease.
- Less common conditions include Addison’s disease, rheumatoid arthritis, lupus, and vitiligo.
- When it comes to diabetes and autoimmune conditions, staying informed, advocating for screening, and promptly addressing new symptoms can lead to earlier treatment and better health outcomes.
- If you’re managing multiple autoimmune conditions, try to build a care team that understands how your specific conditions interact. This team may include specialists such as endocrinologists, gastroenterologists, rheumatologists, dermatologists, and dietitians.
- Living with more than one autoimmune condition isn’t without its challenges, but successful management is absolutely doable.
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Did you ever play with those little green army men as a kid? That’s basically like your immune system – armed, ready, and looking for a fight. Normally, the immune system targets harmful invaders like viruses and bacteria. But in autoimmune diseases, it gets mixed up and mistakenly attacks the body’s own tissues.
In the case of type 1 diabetes, it attacks the insulin-producing beta cells in the pancreas. But there are a bunch of other autoimmune conditions out there, and anyone (with or without diabetes) can get them.
Why does this happen? That’s the zillion-dollar question! Researchers are still trying to figure it out.
What we do know is that people with T1D are at higher risk for developing certain additional autoimmune conditions (because apparently, one autoimmune disease just isn’t enough 😅). We’re going to break down the most common tag-along conditions, how to spot them, and what you can do to manage them.
Thyroid Disease and Diabetes: When Your Thyroid Becomes an Over- or Underachiever
Thyroid disease is the most common autoimmune sidekick to type 1 diabetes. In fact, up to 30% of people with T1D will develop some form of autoimmune thyroid disease during their lifetime. That’s why it’s recommended that everyone with type 1 diabetes get their thyroid function checked when they’re first diagnosed – and then every 1–2 years after that (or sooner if symptoms pop up).
There are two main types of autoimmune thyroid disease: Graves’ disease and Hashimoto’s disease.
Graves’ Disease
Graves’ disease is one of several conditions that can lead to hyperthyroidism. Graves’ disease causes your thyroid to become overactive and go into overdrive, and when your thyroid is running too fast, your body feels it.
Symptoms May Include:
- Unexplained weight loss
- Sensitivity to heat
- Rapid heartbeat
- Bulging eyes
- Feeling anxious
Treatment Options:
- Antithyroid medications
- Radioactive iodine therapy
- Beta blockers
- In some cases, surgery to remove all or part of the thyroid
Hashimoto’s Disease
Hashimoto’s disease (or Hashimoto’s Thyroiditis) slows your thyroid waaay down, and is a condition associated with hypothyroidism. When your thyroid isn’t producing enough hormones, your whole system can feel sluggish.
Symptoms May Include:
- Constant fatigue
- Weight gain
- Sensitivity to cold
- Constipation
- Depression
Treatment Options:
- T4 hormone replacement therapy (like levothyroxine)
- T3 therapy (Liothyronine, also known as Cytomel)
- A combination of T4 and T3 replacement therapy
Interestingly, people who have either type of thyroid condition – but don’t have diabetes – are at a much higher risk of developing type 1 than the general population.
Celiac Disease and Diabetes: When You Have to Say Goodbye to Gluten
Celiac disease affects about 6% of people with T1D – way more than in the general population. Here, gluten (a protein found in wheat, barley, and rye) triggers the immune system to attack the small intestine. What did the intestine do to deserve this? Again, we don’t know.
Symptoms May Include:
- Diarrhea
- Abdominal pain or cramping
- Bloating
- Weight loss
- Fatigue
- Anemia
- Growth issues in children
Everyone with type 1 diabetes should be tested for celiac at diagnosis (but many aren’t), and it’s smart to get retested now and then – especially if you’re having gastrointestinal issues.
Treatment:
The only treatment for celiac is a strict gluten-free diet. Yes, it’s a big lifestyle change, but gluten-free options are everywhere now – from grocery store shelves to restaurant menus. With the right support, pre-planning, and a little label-reading, managing diabetes and autoimmune conditions like celiac is totally doable.
Addison’s Disease and Diabetes: When Your Adrenal Glands Go MIA
Addison’s disease is rare – less than 1% of people with type 1 diabetes will develop it – but it’s still worth knowing about because if it goes undiagnosed or untreated, it can become life-threatening.
Fun fact: President John F. Kennedy had Addison’s disease, but like many things in politics, it was kept under wraps.
So what is Addison’s exactly? It’s when the adrenal glands don’t produce enough of two key hormones: cortisol (your body’s stress responder) and aldosterone (which helps regulate blood pressure and sodium levels). Without them, things can start to unravel.
Symptoms May Include:
- Fatigue
- Unexplained weight loss
- Low blood pressure (especially when standing)
- Salt cravings
- Nausea or vomiting
- Abdominal pain
- Darkening of the skin (especially around scars or skin folds)
- Unexplained low blood sugars
- Increased insulin sensitivity
Treatment Options:
Addison’s disease is treated with daily hormone replacement therapy, usually with medications that mimic the cortisol and aldosterone your body isn’t making.
Steroids like cortisol are pretty important for health, but too much over a prolonged period of time is harmful, as in Cushing’s disease (when the adrenal glands produce excessive amounts of cortisol).
You don’t need routine screening unless you have multiple autoimmune conditions or mysterious symptoms like those mentioned above. In those cases, an adrenal antibody test might be warranted. Addison’s disease may be rare but it’s powerful, and catching it early makes all the difference.
Rheumatoid Arthritis and Diabetes: When Your Joints Are a Pain
Rheumatoid arthritis (RA) is a chronic autoimmune condition that causes inflammation in the joints. It’s not as common in people with type 1 diabetes as some other autoimmune tagalongs, but it can still show up uninvited.
Symptoms May Include:
- Achy or painful joints
- Joint stiffness, especially in the morning
- Swollen, tender joints
- Fatigue
Treatment Options:
There’s no cure (yet) for RA, so treatment is all about dialing down the inflammation, easing pain, and keeping your joints working as best they can.
- NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) like Advil, Motrin, Aleve, and Naprosyn for pain and inflammation
- Steroids to calm flare-ups
- DMARDs (Disease-Modifying Antirheumatic Drugs) like Humira, Enbrel, and others that help slow disease progression
- Physical and occupational therapy
- Surgery if joint damage becomes severe
RA can be persistent, but with the right tools and care team, you can keep it from running the show.
Lupus and Diabetes: When Symptoms Can Be a Mystery
Systemic lupus erythematosus (SLE) – better known as lupus – is an autoimmune condition that can affect many parts of the body, including your skin, joints, kidneys, lungs, and even your brain. While T1D targets beta cells and lupus can affect multiple organs and systems, the underlying processes often involve similar immune system abnormalities.
Lupus is often called “the great imitator” because its symptoms can mimic many other conditions, making it tricky to diagnose. Signs and symptoms vary depending on which body system is affected.
Symptoms May Include:
- Fatigue
- Fever
- Achy, stiff, or swollen joints
- A butterfly-shaped rash across the cheeks and nose
- Skin lesions that appear or flare up with sun exposure
- Shortness of breath
- Chest pain
- Dry eyes
- Headaches, confusion, or memory problems
Lupus looks different in everyone, so treatment is tailored to your specific symptoms and organ involvement. The goal? Control inflammation, prevent flare-ups, and protect organs.
Common Treatment Options Include:
- NSAIDs for pain and inflammation
- Antimalarial drugs (yes, really – they help with skin and joint symptoms)
- Corticosteroids to reduce inflammation
- Immunosuppressants to help calm the overactive immune system
- Biologics for more targeted immune control
Lupus can be unpredictable, but with the right treatment plan, most people can manage it and live well.
Vitiligo and Diabetes: When Skin Loses Its Color
Vitiligo is an autoimmune condition where the body mistakenly attacks its own pigment-producing cells, causing white patches to appear on the skin. Research has shown that both T1D and vitiligo share common genetic risk factors. Vitiligo is not harmful to your health (it’s just cosmetic), but it represents one of many associated autoimmune conditions.
Symptoms May Include:
- Patches of skin losing color, often on the hands, face, around the mouth or eyes, and in the genital area
- Premature graying of hair on the scalp, eyelashes, eyebrows, or beard
- Loss of pigment in the tissues lining the inside of the mouth or nose
Routine screening isn’t needed, but if you start noticing these changes, a visit to a dermatologist can confirm what’s going on.
Treatment Options:
There’s no cure for vitiligo, but there are treatments that can potentially help restore or even out skin tone, though results vary:
- Topical medications to stimulate pigment
- Light-based therapy to even out skin tone
- Cosmetic cover-ups
Frequently Asked Questions
🦠 What is an autoimmune disease?
An autoimmune disease is when your immune system – which normally protects you by fighting off germs like viruses and bacteria – mistakenly attacks your own healthy cells and tissues. In type 1 diabetes, the immune system attacks the insulin-producing beta cells of the pancreas. There are more than 100 different types of autoimmune conditions. Researchers aren’t sure exactly what causes autoimmune diseases, but they often run in families and may be triggered by a mix of genes, viral infections, and other factors in the environment.
🩸 Why are people with type 1 diabetes more susceptible to other autoimmune diseases?
The real answer is, WE DO NOT KNOW! However, some people are born with genes that make them more likely to get autoimmune diseases. And when your immune system is already in attack mode, it can be easier for it to “go rogue” again. That’s why doctors often check for other autoimmune diseases after a type 1 diagnosis.
🧐 What is autoimmune polyendocrine syndrome?
Autoimmune polyendocrine syndrome (APS) is a common condition where the immune system mistakenly attacks multiple hormone-producing glands in the body. This leads to a combination of autoimmune diseases, such as T1D, thyroid disorders, Addison’s disease, and often celiac disease. Simply, if you have two autoimmune conditions like T1D and celiac, then by definition you have APS. APS is caused by a mix of genetic, immune system factors, and environmental influences. Symptoms can vary depending on which glands are affected. It’s manageable with proper medical care, but it requires regular monitoring and treatment of the different hormone-related issues it causes.
Key Takeaways
Anyone with or without diabetes can get an autoimmune disease, but people with type 1 diabetes can be more susceptible to certain conditions. Thyroid disease and celiac disease are the most common for people with T1D.
The best way to stay on top of things when it comes to diabetes and other autoimmune conditions? Keep an eye out for new or changing symptoms, and reach out to your healthcare team if something feels off.
If you find yourself juggling more than one autoimmune disease, know you’re not alone, and you don’t have to navigate them alone. Look for providers who understand how your conditions interact – they can help connect the dots across your whole health picture. And don’t forget about taking care of your mental health – there are great therapists around the country who specialize in supporting people living with chronic conditions.
Managing even ONE autoimmune condition is a lot – but so is assembling IKEA furniture, and people survive that too.
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