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June 26, 2005

Diagnosis and Symptoms, Other Illnesses

Question from Easton, Massachusetts, USA:

My daughter was diagnosed with type 1 diabetes in November 2003. There is absolutely no one on either side of our family who is diabetic. Earlier that year, way before any signs of diabetes, she was anemic. Her pediatrician ordered extra iron and we dutifully gave it to her. Months later, we increased the iron dose and kept at it until she was no longer anemic. I had also asked if she could possibly have Graves disease, since I had it and noticed she had many of the symptoms (always hot, shaky hands, etc). I was told it was rare in kids and highly unlikely and, unfortunately, I did not push to have her tested. Eventually, she was no longer anemic and off we went. I cannot shake the feeling that somehow, between the anemia and Graves, which was confirmed by her endocrinologist, something happened that caused her diabetes. There are web sites proclaiming a connection between iron overload and diabetes. Is there any research showing any connection?


Iron overload can cause a type of pancreatic damage called hemosiderosis. It is unlikely that a short term iron treatment would do this unless the dose was extraordinarily high or prolonged.

Thyroid problems are associated with type 1 and type 2 diabetes. Type 1 diabetes and most thyroid problems that are acquired are autoimmune in nature and about 20% (some would say 40%) of youngsters with type 1 diabetes will have laboratory tests indicating thyroid antibodies present, goiters, hypothyroidism or hyperthyroidism. Exactly why one person just has a goiter, another becomes hypothyroid and another becomes hyperthyroid is not understood.

Anemia can be from positive gastroparietal antibodies, pernicious anemia, interference with iron absorption or celiac disease. Many of us routinely check thyroid status and celiac disease as well as kidney and lipid status because of how common such problems co-exist. Adrenal insufficiency (Addison’s disease) also is a more rare but related autoimmune problem with these others, as is vitiligo.

So, go back and discuss this with your diabetes team and then they can give you more specific answers to your questions. There is an article that I wrote many years ago for Diabetes Forecast that summarizes some of this. If you can locate some old issues or check the ADA web site, this also may be helpful.