Other Diseases That Are More Common in People With Type 1 Diabetes

Kids and teens with type 1 diabetes have a greater risk for other health problems, many of which also are autoimmune disorders. The diabetes health care team will watch kids for signs of these problems. But parents also should know what to look for so that they can alert doctors and get treatment, if necessary.

What Are Autoimmune Disorders?

In autoimmune disorders, the immune system attacks the body's healthy tissues as though they were foreign invaders. A severe attack can affect how that body part works.

Type 1 diabetes is an autoimmune disease. The pancreas can't make insulin because the immune system attacks it and destroys the cells that produce insulin. Kids and teens with type 1 diabetes are at risk for other autoimmune problems, but these aren't actually caused by the diabetes.

Doctors still aren't exactly sure why autoimmune diseases happen. But genetics probably play an important role because relatives of people with type 1 diabetes are more likely to have autoimmune diseases.

Most kids with type 1 diabetes never need treatment for any other autoimmune disorder. But those who do might develop:

• thyroid disorders
• celiac disease
• Addison's disease

These disorders can develop before a child is diagnosed with type 1 diabetes or months or years after the diabetes diagnosis.

What Are Thyroid Disorders?

Kids and teens with type 1 diabetes are more likely to get disorders affecting the thyroid. The thyroid, which is part of the endocrine system, makes hormones that help control metabolism and growth. These hormones play a role in bone development, puberty, and many other body functions.

Thyroid disease is fairly common in people with type 1 diabetes, affecting 15% to 20% of them.

In thyroid disease, the thyroid gland might make too much thyroid hormone (hyperthyroidism) or too little hormone (hypothyroidism). Both hyperthyroidism and hypothyroidism can be accompanied by an enlarged thyroid gland, called a goiter, though it's not always visible.

Hyperthyroidism can cause nervousness, irritability, increased sweating, intolerance to heat, tiredness, sleep problems, a fast heartbeat, irregular menstrual periods in girls, and muscle weakness. People also might lose weight even though they're eating more than usual. The eyes may feel irritated or look like they're staring. Sometimes the tissues around the eyes become inflamed and swollen, and the eyes appear to bulge out.

Someone with mild hypothyroidism may feel just fine and have no symptoms. But symptoms can become more obvious if the condition gets worse. People with underactive thyroids might feel depressed and sluggish, or gain weight even though they're not eating more or getting less exercise than usual. Kids with hypothyroidism also might have slow growth in height, slow sexual development, irregular menstrual periods in girls, muscle weakness, dry skin, hair loss, poor memory, and trouble concentrating.

To check for thyroid disorders, the doctor may ask about symptoms and feel your child's neck for an enlargement of the thyroid gland or order blood tests.

Kids with thyroid problems might take prescription medicine to bring their thyroid hormone levels back to normal.

What Is Celiac Disease?

Celiac disease is an autoimmune disorder that affects about 1 in 20 people with type 1 diabetes. It affects the intestine's ability to tolerate the protein gluten, which is found in grains like wheat, rye, and barley.

When kids with celiac disease eat foods containing gluten, their immune systems react to it, causing gastrointestinal symptoms. Over time, exposure to gluten damages the small intestine and prevents it from properly absorbing nutrients from food.

Some people have no symptoms, but others may have frequent diarrhea, abdominal pain, gas, bloating, weight or appetite loss, or tiredness. Some kids and teens have growth problems because they aren't getting enough nutrients. If not treated, celiac disease can lead to hypoglycemia, osteoporosis (a disease that causes brittle, fragile bones), and some types of cancer.

If your child has type 1 diabetes, your doctor may do a blood test to check for celiac disease, even if there are no symptoms. If the doctor suspects celiac disease, your child might undergo a small-bowel biopsy (the removal of a piece of tissue from the small intestine for examination) to confirm the diagnosis.

Kids and teens who have celiac disease must follow a gluten-free diet (no wheat, rye, and barley products). They'll still need to eat a balanced diet to stay healthy and maintain good control of blood sugar levels, though. So the doctor may recommend that you meet with a registered dietitian to learn about choosing and preparing gluten-free foods.

What Is Addison's Disease?

Addison's disease, a type of adrenal insufficiency, affects the adrenal glands of the endocrine system. These glands make hormones, including cortisol and aldosterone, that help control many body functions, particularly those related to its response to stress. They affect blood pressure, fluid balance, heart function, the immune system, the body's response to insulin, metabolism, and a person's sense of alertness and well-being. In Addison's disease, the adrenal glands don't produce enough cortisol and also might not make enough aldosterone.

Signs and symptoms of Addison's disease start slowly. They include tiredness, muscle weakness, appetite loss, or weight loss. Some people have nausea, vomiting, diarrhea, dizziness and low blood pressure, skin discoloration (especially in skin creases, like the elbows), irritability, depression, or irregular periods.

For about 1 in 4 people with Addison's disease, symptoms don't appear until they're triggered by a stressful event, such as illness or an accident. These symptoms can be more severe and come on suddenly. This is called an addisonian crisis, or acute adrenal insufficiency. If this happens to your child, it's important to get medical help immediately.

When doctors suspect Addison's disease, they'll run tests, including urine (pee) and blood tests, to diagnose it. The condition is treated with medicine to bring adrenal hormone levels back to normal.

How Can I Help My Child?

You can't prevent these health problems related to type 1 diabetes. But the good news is that thyroid disorders, celiac disease, and Addison's disease usually can be treated successfully.

Knowing which signs and symptoms to watch for and making sure your child gets regular checkups will help reduce or prevent the effects of these disorders.