Sjogren’s syndrome, which affects between one and four million Americans, is an autoimmune condition that can accompany other immune disorders, including lupus and rheumatoid arthritis. This condition can impact the whole body, and can lead to serious complications that impact internal organs. Since April happens to be Sjogren’s Awareness Month, what better time to learn more about this condition and also find out if having diabetes can put you at risk.
What is Sjogren’s syndrome?
Sjogrens (pronounced “SHOW-grins) is “a chronic autoimmune disorder that happens when the immune system attacks the glands that make moisture in the eyes, mouth, and other parts of the body,” says the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
People affected with this condition may have mild symptoms or debilitating symptoms, according to the Sjogren’s Foundation. About half of the time, Sjogren’s occurs alone (primary form), but it’s also likely to occur when another autoimmune disease is present, such as rheumatoid arthritis, lupus, or scleroderma (secondary form). There’s no cure for this condition, but there are ways to manage and treat it.
Who gets Sjogren’s syndrome?
Most of the people who have Sjogren’s are women. In fact, ten times as many women as men are diagnosed with this condition, and most women are diagnosed during middle age or after menopause, according to the American College of Rheumatology. But, Sjogren’s can affect people of any age, including children.
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What are the symptoms of Sjogren’s?
Symptoms of Sjogren’s can vary from person to person, can be mild or severe, and may have different effects on the body. The main symptoms are:
- Dry eyes. The eyes feel gritty or itchy, and they may burn. Dryness can cause blurry vision and light sensitivity. The eyelids can become inflamed, too, causing irritation and itching.
- Dry mouth. The mouth can feel chalky, and it may be difficult to taste, eat, swallow, and speak. Cavities and mouth infections, such as thrush, can occur due to a lack of saliva.
Because Sjogren’s can affect other tissues and organs in the body, as well as the eyes and mouth, other side effects can include:
- Joint pain or stiffness
- Dry skin and lips
- Dry nasal passages and throat
- Vaginal dryness
- Skin rashes
- Muscle aches and weakness
- Acid reflux
- Swollen glands around the face and neck
- Numbness, tingling and weakness in the extremities
- Shortness of breath or trouble breathing
- Recurrent lung problems, such as pneumonia, bronchitis, and interstitial lung disease
- Digestive tract problems, such as irritable bowel syndrome (IBS)
- Kidney problems
- Trouble sleeping
- Poor concentration and memory problems
Also, people with Sjogren’s have a higher chance of developing lymphoma, a cancer of the lymphatic system, although the risk is low.
What causes Sjogren’s syndrome?
Researchers aren’t sure what causes Sjogren’s, but they suspect that both genetic and environmental factors are involved. The American College of Rheumatology states that “genetic factors and sex hormones when combined with an environmental agent, such as a viral infection, may trigger the development of the disease.”
Are people with diabetes at a higher risk of getting Sjogren’s syndrome?
Researchers from the Graven Institute of Medical Research in Sydney, Australia, identified immune cells in mice that link type 1 diabetes and Sjogren’s syndrome. Another study, published in the British Journal of Rheumatology in 1989, looked at 102 patients with type 1 diabetes and found Sjogren’s symptoms affecting 55% of them. However, more research is needed to determine if and to what extent there is a link between these two autoimmune conditions.
Of note, research published in Frontiers in Medicine in January 2022 indicates that people age 60 years or older with type 2 diabetes who were taking metformin had a lower risk of developing Sjogren’s, possibly due to metformin’s anti-inflammatory and immune-modulatory mechanisms.
How is Sjogren’s diagnosed?
Sjogren’s can be difficult to diagnose as the signs and symptoms, such as dry eyes and dry mouth, can be caused by many other conditions or medications. However, if a person has these or other symptoms that could indicate Sjogren’s, their primary care provider or a rheumatologist may order certain tests to help rule out other conditions. These tests include:
- Blood tests to check for antibodies that are usually present in people with Sjogren’s
- Eye tests to check for tear production and to check for damage from dry eye
- Salivary gland tests to measure saliva production, including ultrasound and biopsy to see if salivary gland tissue is affected by inflammation
- Additional laboratory tests or imaging tests, based on other symptoms a person is having
How is Sjogren’s treated?
The goal of treatment is focused on relieving symptoms and preventing complications. Again, treatment varies for each person, based on symptoms and affected areas in the body. Treatment likely will include a combination of self-care behaviors, plus over-the-counter and prescription medication. Examples of these are:
- Artificial tears
- Eye ointments
- Plugs to block tear ducts
- Artificial saliva
- Medicine to stimulate saliva production
- Anti-fungal medication to treat thrush
- Pain relievers
- Corticosteroids to control pain and inflammation
- Medicines called Disease-Modifying Anti-Rheumatic Drugs (DMARDS) that modify the way the immune system functions — examples are methotrexate, hydroxychloroquine, and azathioprine
- Biological therapies, such as rituximab (Rituxan) may be used in severe cases
Self-care treatments can also help to make living with Sjogren’s easier and more comfortable. Examples of self-care treatments are:
- Protecting the eyes from breezes and smoke
- Using a humidifier
- Using warm compresses on the eyes
- Brushing and flossing teeth regularly
- Sipping on water frequently
- Using saline sprays for the nose
- Using lip balm and skin moisturizers
- Eating a healthy diet, such as the Mediterranean-style diet
- Getting enough physical activity
- Getting enough sleep
A person with Sjogren’s will likely need a team of providers, including their primary care provider, a rheumatologist, a dentist, and an ophthalmologist. Other specialists may be part of the team, too, including a nephrologist, pulmonologist, and a mental health provider.
For more information about Sjogren’s syndrome, visit the website of the Sjogren’s Foundation.