Children diagnosed with type 1 diabetes often face more than just the challenges of managing their blood sugar. Many also develop additional autoimmune diseases and experience significant mental health struggles as they navigate strict dietary and medical routines.
A Complex Diagnosis
Raquel Pérez Castiñeiras, a mother from Milladoiro, Spain, recalls when her eldest daughter Clara, at just three years old, began showing unusual symptoms: mood swings, excessive thirst, bedwetting, and fatigue. These were early signs of type 1 diabetes, a condition where the immune system attacks the insulin-producing cells in the pancreas. Soon after, Clara was also diagnosed with celiac disease and, later, hypothyroidism.
Clara’s story reflects a common pattern among young people with type 1 diabetes. Many develop other autoimmune disorders, such as celiac disease, which affects the small intestine, or thyroid disorders like Hashimoto’s thyroiditis and Graves’ disease. According to Dr. Belén Roldán of the Pediatric Endocrinology and Diabetes Unit at Ramón y Cajal Hospital in Madrid, these comorbidities stem from the same genetic predispositions and immune system malfunctions that trigger type 1 diabetes.
The Burden of Multiple Conditions
Dr. Roldán recently presented a study at the Spanish Diabetes Society (SED) conference, highlighting the additional burden these co-occurring conditions place on families. The study, which followed 490 children aged six months to 18 years, found that 7.5% of them also had celiac disease—far higher than the 1% seen in the general population. For many, this diagnosis came within the first year after their diabetes diagnosis.
Managing both diabetes and celiac disease is especially challenging. Families must not only regulate blood sugar through diet, exercise, and insulin but also adhere to a strict gluten-free diet, which introduces new dietary complexities and glucose management challenges. Despite the difficulty, experts emphasize that with proper management, children with both conditions can thrive just as well as those with only diabetes.
Thyroid Disorders and Early Detection
The thyroid gland is another target of autoimmune attacks in children with type 1 diabetes. A study in Frontiers in Endocrinology reports that thyroid autoantibodies are found in 17% to 30% of these children, compared to less than 5% in the general pediatric population. Fortunately, many of these conditions are detected early through routine screenings, allowing for early intervention and better diabetes control.
The Mental Health Struggle
Beyond physical health, type 1 diabetes significantly affects mental health. Adolescents with the disease are 48% more likely to experience anxiety compared to their peers, according to research presented by Dr. Marisol Ruiz de Adana from the Diabetes Unit at the Regional Hospital of Málaga. Teenagers must make up to 70 health-related decisions daily, from counting carbohydrates to adjusting insulin doses, which can be overwhelming.
A study of 46 adolescents transitioning from pediatric to adult diabetes care found that 32% experienced moderate to severe anxiety and 34% showed signs of depression. Dr. Ruiz de Adana warns that these mental health issues can lead to avoidance behaviors, poor glucose control, and long-term health consequences if not addressed promptly.
Eating Disorders: A Growing Concern
Children and adolescents with type 1 diabetes are also at greater risk for developing eating disorders. A recent meta-analysis covering 46 studies found that up to one in four insulin-dependent patients over age 16 show symptoms of disordered eating, with a higher prevalence among females. The constant attention to diet and insulin management increases their vulnerability.
María José Ortega, a clinical psychologist in Madrid, explains that the strict control required for diabetes management often exacerbates the risk of developing unhealthy eating behaviors.
The Role of Summer Camps
One strategy that has proven beneficial for both physical and emotional health is participation in diabetes summer camps. In these supportive environments, children can socialize, build self-esteem, and learn effective self-care routines from peers and trained counselors, many of whom also have diabetes.
According to Ana Gómez Perea, an advanced practice diabetes nurse at the Regional Hospital of Málaga, these camps not only improve glucose management and insulin administration but also enhance emotional well-being, quality of life, and parental mental health.
New Treatments on the Horizon
While researchers continue to explore new treatments, such as teplizumab—a drug that can delay the onset of type 1 diabetes by up to two years—the challenge remains to identify at-risk individuals early. Currently, only about 10% of patients have a first-degree relative with the disease, the strongest known risk factor.
As Dr. Francisco Javier Ampudia-Blasco, president of the Spanish Diabetes Society, emphasizes, the future lies in developing screening programs that can identify risk in the broader population, representing the next great challenge in managing type 1 diabetes.