Sometimes, people who live with one autoimmune disease, like type 1 diabetes, are diagnosed with other conditions where the immune system attacks the body. For example, people with type 1 diabetes might also be diagnosed with rheumatoid arthritis (RA).

“I was diagnosed with type 1 diabetes in 1989, and then I was diagnosed with RA in 1992,” one myT1Dteam member wrote. “It’s been a battle dealing with both diseases.” Another member said, “My joints hurt and I need to see a doctor. But I just cannot deal with another issue.”

If you have type 1 diabetes and RA, it can make treating both conditions more challenging. Here’s what you need to know if you think you may have RA or if you’ve already been diagnosed with it.

Type 1 Diabetes and RA

Type 1 diabetes is an autoimmune disease. With type 1 diabetes, the body’s immune system attacks cells in the pancreas that produce insulin. RA is also an autoimmune condition. It occurs when your immune system attacks the tissue lining your joints.

If you’ve been diagnosed with one autoimmune condition, you’re more likely to be diagnosed with another. About 25 percent of people who have an autoimmune disorder eventually develop an additional autoimmune condition.

One study found that people with RA were at higher risk of also having type 1 diabetes than those in the general population. They also noted that study participants were typically diagnosed with diabetes before being diagnosed with RA.

Another study found that people with type 1 diabetes had a high likelihood of developing rheumatic diseases, like RA. The risk was higher among women than men.

Is There a Genetic Connection?

Having certain genes may make it more likely that someone will be diagnosed with both RA and type 1 diabetes. These genes include:

• TNFAIP3
• PTPN22
• CTLA4

If you’ve had any genetic testing, you may know whether you have one of these genes. You can talk to your doctor to determine if genetic testing is appropriate.

RA Symptoms To Watch For

Due to the increased risk of developing RA, people with type 1 diabetes should be aware of RA symptoms. That way, if they occur, you can contact your endocrinologist or a rheumatologist right away. Rheumatologists are specialists who treat RA.

Some of the most common signs of RA include:

• Stiff joints, especially at the base of your fingers and toes (never at the joint at the tip of the finger)
• Painful, swollen joints that may also be tender and warm to the touch
• Joint stiffness in the morning that lasts more than 30 minutes and gets better with movement, or stiffness when you have not been active for a while
• Tiredness
• Loss of appetite, which may lead to weight loss
• Fever

Not all RA symptoms affect the joints. You may also notice problems in your lungs, eyes, skin, kidneys, salivary glands, and more. If you have any unusual symptoms, ask your doctor about getting tested for RA or your risk factors for developing the condition.

How Is RA Diagnosed?

If you think you might be experiencing RA symptoms, your doctor will examine you, ask about the symptoms you’ve had, and order testing. Although there’s no single test that can diagnose RA, some blood tests may help doctors make a diagnosis.

These tests include:

• A complete blood count
• Liver and kidney labs
• A rheumatoid factor test
• An erythrocyte sedimentation rate (ESR) test
• A C-reactive protein (CRP) test
• An anti-cyclic citrullinated peptide (anti-CPP) test.

Your care team may perform all of these tests or just a few of them.

Your doctor may also perform imaging tests to look for signs of inflammation and damage to your cartilage. These may include X-rays, MRI scans, and ultrasounds.

How Rheumatoid Arthritis Is Treated

If you’re diagnosed with RA, your doctor will develop a treatment plan that considers the severity of your symptoms and your overall health. Treatments may include nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, disease-modifying antirheumatic drugs (DMARDs), biologics, or other options. Your doctor may also offer advice on lifestyle adjustments that can help ease your RA symptoms.

Make sure your rheumatology team knows about your type 1 diabetes diagnosis. Some RA medications may make it challenging to manage diabetes.

For example, corticosteroid medications (such as prednisone) can cause your blood glucose levels to rise, lowering insulin’s effectiveness. Your doctor also may ask you not to take NSAIDs (such as ibuprofen). When taken long-term, NSAIDs may affect heart and kidney function. Some NSAIDs can induce low glucose levels in people with diabetes.

Always talk to your doctor about the best treatment options for your symptoms and conditions.

Managing Type 1 Diabetes and RA at the Same Time

If you have both type 1 diabetes and RA, you could face new challenges. RA symptoms could limit your finger dexterity, making it harder to give yourself insulin injections or monitor your glucose.

If this occurs, you may want to consider getting a continuous glucose monitor and an insulin pump. Depending on how they’re configured, these devices can work together to monitor your blood sugar levels and automatically deliver insulin when you need it. This can make managing diabetes easier if you experience stiff finger joints.

Talk to your doctor about how to manage any effects of one condition and how it impacts the other.

Can You Lower Your Risk of Developing RA?

Even though genetics may guide whether you’re at risk of developing RA, there are some factors you can change that may help curb your risk. Some of these lifestyle adjustments may also help you live healthier overall.

For instance, eating a balanced diet that includes vegetables, fish, and healthy fats like olive oil can help you lower your RA risk. These foods may also improve your health with type 1 diabetes.

Stopping or avoiding smoking is another way to curb your risk for RA. Many studies have shown that smoking is a risk factor for developing RA and for the severity of the disease. Smoking can also affect people with type 1 diabetes, as it can make cells respond less to insulin.

Maintaining a healthy weight can help in RA prevention because carrying too much weight can cause inflammation throughout your body. This can cause fat cells to release cytokines, or proteins that damage joint tissue — a key factor in the development of RA. Staying at a healthy weight is also helpful for people with type 1 diabetes. Your body may have trouble using insulin the right way if your weight rises too high.

Discuss your RA risk with your doctor so you can develop a prevention plan that works for you and allows you to keep your type 1 diabetes symptoms in check.

Talk With Others Who Understand

On myT1Dteam, the social network for people with type 1 diabetes and their loved ones, more than 3,700 members come together to ask questions, give advice, and share their stories with others who understand life with type 1 diabetes.

Are you living with type 1 diabetes along with rheumatoid arthritis? Share your experience in the comments below, or start a conversation by posting on your Activities page.