Care
Type 1 diabetes and other autoimmune conditions For most people, type 1 diabetes will remain the single autoimmune condition that they deal with. However, about a fifth of those with type 1 will develop at least one other autoimmune condition. This overview looks at some of the most common and some of the rarest.
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utoimmune illnesses – where the body mistakenly turns its own immune system against itself – can be hereditary. These illnesses may cluster together in individuals and in families. In type 1 diabetes, the body destroys its own insulin-producing cells in the pancreas. Last year, a Finnish study found that – out of 4000 people living with type 1 – 22.8% had at least one other autoimmune condition.1 The researchers recommended that people with type 1 should be regularly screened for additional autoimmune illnesses. At the moment, here in New Zealand, the system is variable from region to region, and those with type 1 are sometimes – not always – screened for coeliac disease and thyroid disease. If you live with or care for someone with type 1, it’s good to be aware of the symptoms of these and other autoimmune illnesses, so you can keep an eye out, and push for tests from your doctor if you suspect something. If your doctor knows you already have – or a family member already has – an autoimmune illness, this can help with getting tests for others. Many autoimmune conditions are similar to type 1 in their unpredictability and in the way that their progression varies from person to person. It means specialist individualised care, good information, and peer support are vital.
1 ‘ Every Fifth Individual With Type 1 Diabetes Suffers From an Additional Autoimmune Disease: A Finnish Nationwide Study’. doi.org/10.2337/dc19-2429.
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DIABETES WELLNESS | Winter 2021
Coeliac disease In coeliac disease, the immune system sees substances in gluten as a threat and attacks them, damaging and inflaming the small intestine, and interfering with its ability to absorb nutrients from food. SYMPTOMS
Some of the most common symptoms of coeliac disease include fatigue, weakness, lethargy, anaemia from iron or folic acid deficiency, weight loss, osteoporosis, diarrhoea or chronic constipation, wind, cramping, bloating, and nausea. There is also a range of rarer symptoms that include (but are not restricted to) easy bruising of the skin, mouth and tongue swelling and ulcers, miscarriages and infertility, and skin rashes – particularly dermatitis herpetiformis. Coeliac disease affects more women than men. DIAGNOSIS
A coeliac diagnosis can take some time, especially if you have some of the less common symptoms. Research indicates that a number of people who have coeliac disease are unaware of it. Tests may include blood tests, biopsies of the small bowel, and tests for genetic markers associated with coeliac disease. If you think you might have coeliac disease, it’s very important that you don’t start a gluten-free diet before the diagnosis process, as this can affect the process and the results. TREATMENT
The only way to manage coeliac is by going strictly gluten free. Pharmac offers part-funding for some gluten-free foods, such as gluten-free flour, glutenfree pasta, and gluten-free bread mix or baking mix. This is available by prescription only. For more information and support: coeliac.org.nz
