Type 1 diabetes is an autoimmune condition where the body’s immune system destroys the cells producing insulin. Insulin is a hormone that helps the cells absorb glucose from the food you eat. As insulin is insufficient in Type 1 diabetes, glucose cannot be efficiently utilized by your body, increasing its blood level. Certain complications associated with Type 1 diabetes, such as kidney damage, are responsible due to iron deficiency, which may also alter sugar levels. Iron deficiency or anemia, is a common condition affecting 20%-25% of the world’s population. Iron is an essential nutrient, and its deficiency is associated with decreased quality of life. Talk to your doctor to have your iron levels checked if you have Type 1 diabetes.

Type 1 Diabetes and Iron Deficiency Risk

The following Type 1 diabetes-associated complications may increase the risk of iron deficiency.

Diabetic Nephropathy

Anemia is a condition where the body produces fewer red blood cells. Kidneys produce hormones called erythropoietin that regulate the formation of red blood cells. These blood cells are responsible for carrying oxygen to the rest of the body. Failing to manage sugar levels in diabetes may damage the part of the kidneys that filter blood. The damaged kidney cannot produce enough EPO, resulting in fewer red blood cells. Damaged kidneys need hemodialysis to manage the purification of blood, resulting in loss of blood and nutrients such as iron. In conclusion, diabetic nephropathy may result in fewer red blood cells and iron deficiency.

Nephropathy

Abnormal sugar levels may also damage nerves responsible for controlling involuntary functions of the body, resulting in a condition known as autonomic neuropathy. In this case, the body is unable to signal the kidneys to produce erythropoietin adequately, ultimately resulting in fewer red blood cells and anemia.

Celiac Disease

There is a genetic link between Type 1 diabetes and celiac disease, and having Type 1 diabetes increases the risk of celiac disease. Celiac disease is an autoimmune disease where gluten ingestion triggers the immune response and damages the small intestine. In addition to gluten, celiac disease also hampers the absorption of other nutrients, including iron.

Symptoms of Type 1 Diabetes and Iron Deficiency Anemia

As the body gets less oxygen, you feel weak and fatigue. Some common symptoms include:

• Dizziness
• Pale skin
• Cold feet and hands
• Shortness of breath
• Headache
• Chest pain
• Rapid heartbeat
• Low body temperature

Type 1 Diabetes and Iron Deficiency Anemia Diet

If you are deficient in iron, your doctor may advise iron-rich foods like:

• Beans
• Chicken and beef
• Squash and pumpkin seeds
• Dried fruits
• Green leafy vegetables such as spinach
• Eggs
• Seafood such as sardines, oysters, clams, shrimp
• Iron-fortified cereals

Vitamin C boosts absorption of iron, including vitamin-C rich foods which improve iron levels. Some sources of vitamin C include:

• Broccoli
• Green and red bell peppers
• Fruits such as grapefruits, kiwis, oranges, and melons
• Cauliflower
• Brussels sprouts
• Tomatoes

Iron Supplements for Type 1 Diabetics

The doctor may prescribe over-the-counter iron supplements to manage iron-deficiency. Iron can also be taken in liquid form, especially by children and infants. The doctor will decide on an ideal dose based on your diagnosis.

To improve iron absorption, your doctor may advise the following:

• Avoid taking the iron supplement with antacids: Medications that help manage heartburn are seen to alter iron absorption. It is recommended to take iron supplements 2-4 hours after taking antacids.
• Take it on an empty stomach: Taking it on an empty stomach improves its absorption. However, if it upsets your stomach, it is a good idea to take it with meals.
• Take Vitamin C: Vitamin C boosts the absorption of iron. Your doctor might advise taking iron tablets with vitamin C supplements or orange juice.

Iron supplements may also cause constipation. In such cases, the doctor would prescribe a stool softener, or perhaps incorporating more fiber into your diet.

Foods that decrease iron absorption and thus should be avoided taking with iron supplements are:

• Caffeine
• Milk
• High fiber foods
• Antacids

You may feel better within a few days of taking iron supplements, but do not stop taking supplements without consulting your doctor first. It takes several months for your body to build the iron amount essential for your body. Also, consult your doctor before taking iron supplements. If the dose is incorrect, excess iron could build in blood, resulting in iron poisoning.

Final Thoughts

Iron deficiency or anemia and Type 1 diabetes are often inter-linked.  Certain diabetes-related complications such as nephropathy and neuropathy increase the risk of iron deficiency. If you have symptoms of iron deficiency, you should ask your doctor about getting your levels checked. Based on your levels and condition, the doctor might prescribe over-the-counter iron supplements.

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