My granddaughters (ages two and four) both have type 1 diabetes. Are they more prone to develop other autoimmune diseases? Could they have polyglandular autoimmune syndrome?

The answer to both questions is “yes.” Some autoimmune diseases are more commonly associated with type 1 diabetes (thyroid disease especially and now more evidence about celiac disease). In addition, other autoimmune diseases such as adrenal insufficiency, lupus, vitiligo, rheumatoid arthritis, and pernicious anemia can occur also.

The polyglandular autoimmune presentations can include those plus ovarian or testicular autoimmune inflammation in girls and boys, respectively, as well as a calcium imbalance (hypoparathyroidism). Affected individuals are at risk for recurrent fungal infections, generally of the skin and membranes.

Your granddaughter’s diabetes team can give you more details and outline any potential screening plan. It generally is not terribly cost-effective to “screen” for most of these — other than thyroid levels and perhaps celiac disease since the other conditions often can be looked for based on history and physical findings.

DS