Estimated reading time: 5 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
Rheumatoid arthritis (R.A.) and type 1 diabetes (T1D) are both autoimmune diseases. This means they are conditions in which the body’s immune system mistakenly attacks itself. It can seem like on the surface this is enough of a connection that they may have the same cause or root. However, they affect widely different parts of the body. So - what exactly is the connection between these two conditions? To understand this, you first need to understand both R.A. and T1D. Here is a guide from PatientsLikeMe.
What Are T1D and R.A.?
Type 1 Diabetes (T1D)
Type 1 diabetes is an autoimmune condition where the immune system attacks the pancreas. This destroys the cells that produce insulin. Insulin is a hormone that helps regulate blood sugar levels. Without it, blood sugar can get dangerously high, requiring people to rely on insulin injections or pumps to manage their condition.
Symptoms of T1D:
- Increased thirst and urination
- Unexplained weight loss
- Fatigue
- Blurred vision
Click here to learn more about Type 1 Diabetes.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis is an autoimmune disease where the immune system attacks the lining of the joints, causing inflammation. Over time, this can lead to joint pain, swelling, and damage. In severe cases, it can affect other organs as well.
Symptoms of RA:
- Joint pain, swelling, redness, or warmth
- Fatigue
- Fever
- Stiffness, especially in the morning
- Loss of joint function
What Causes These Conditions?
Both T1D and R.A. share similar underlying causes. For starters, they are both autoimmune conditions. The immune system is attacking healthy tissue. There are also certain genes that increase someone's risk for developing an autoimmune condition. For both R.A. and T1D, there is one genetic risk factor researchers have found that is shared! This is the 620W allele of a protein called tyrosine phosphatase N22. There are also others that have been identified that are actively being looked at. Some environmental triggers are thought to kickstart both T1D and R.A. in people. Viral infections, stress, pollution - there are a number of potential causes.
Risk For R.A. in People with T1D
People with T1D are at a higher risk of developing R.A. because of the shared autoimmune and inflammatory processes. Both conditions are associated with specific genetic markers that increase susceptibility to autoimmune diseases. If you have one condition, your immune system may be more likely to malfunction in other ways. This increases your risk of developing other autoimmune conditions. Chronic inflammation plays a role in both conditions as well. Elevated levels of inflammatory substances can contribute to joint damage and worsen blood sugar control.
Treating R.A. and T1D
Managing both of these conditions simultaneously takes careful consideration. Some medications used for R.A. can affect blood sugar levels. Treatment for rheumatoid arthritis mostly involves three types of medication: DMARDs, biologics, and steroids. T1D on the other hand mostly focuses on insulin therapy and healthy lifestyle changes.
R.A. Treatments
- Disease-Modifying Antirheumatic Drugs (DMARDs)
- Methotrexate, hydroxychloroquine.
- Reduce inflammation and prevent joint damage.
- May improve blood sugar control by lowering inflammation.
- Biologic Therapies
- Adalimumab, etanercept.
- Target specific immune pathways to reduce inflammation.
- Can increase the risk of infections.
- Steroids
- Prednisone.
- Quickly reduce inflammation during RA flares.
- Steroids can raise blood sugar levels, requiring adjustments in insulin or diabetes medications.
T1D Treatment
- Insulin Therapy
- Injections, insulin pumps.
- Keep blood sugar levels within a healthy range.
If you do have both conditions, there are a few things to keep in mind! The first is to work closely with your healthcare team. Make sure your endocrinologist and rheumatologist are aware of both conditions. They can coordinate treatments, dietary recommendations and exercise guidance to minimize side effects. Monitor your blood sugar levels regularly. Steroids or biologics prescribed for R.A. can impact these levels. You also need to pay close attention to any infections. Some treatments for R.A. can weaken your immune system. If you do have T1D, you are already at a higher risk of getting an infection. Make sure you stay up to date on vaccinations and talk about any signs with your doctor.
Having both type 1 diabetes and rheumatoid arthritis can make managing your health more complex, but understanding the connection between the two conditions can help you take proactive steps. By focusing on reducing inflammation, managing blood sugar levels, and working with a knowledgeable healthcare team, it’s possible to live well with both conditions. If you’re experiencing new joint pain or swelling and have T1D, don’t hesitate to reach out to your doctor—it’s always better to catch RA early to prevent long-term complications.
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