Celiac Disease and Type 1 Diabetes

Monitoring blood glucose. Reading food labels. Counting carbs. Isn’t this enough? Why would a person with type 1 diabetes and no symptoms also have to worry about celiac disease? Actually, type 1 diabetes and celiac disease have a lot in common. For one thing, they are both autoimmune disorders. In autoimmune disorders, the disease-fighting cells of the body—otherwise known as the immune system—mistakenly begin to attack the body’s own tissues. In type 1 diabetes, the immune system attacks the pancreas, and in celiac disease, it attacks the small intestine. Both diseases also are inherited and share some of the same genes that regulate the immune system.

What is Celiac Disease?

Celiac disease causes damage to the small intestine and can decrease the absorption of nutrients from food. Undiagnosed celiac disease can lead to anemia, osteoporosis, infertility, the development of other autoimmune disorders and even cancer. It can be diagnosed only by a gastroenterologist, a doctor who specializes in diseases of the digestive system.

While the external trigger for diabetes remains unknown, one trigger for the development of celiac disease is a substance in food called gluten. This difference is crucial because it means that people with celiac disease can treat their condition by avoiding gluten. This has two very important implications: the intestine can repair the damage the disease caused, and the individual who follows a 100 percent gluten-free diet can avoid malnutrition and other serious complications. Like type 1 diabetes, celiac disease cannot be cured. The only treatment is a life-long gluten-free diet. Researchers have established that 10 percent of people with type 1 diabetes have been found to have celiac disease, as well. They also have determined that 2 percent of immediate family members of those with type 1 diabetes also have celiac disease. Many people with diabetes and their immediate family members have no symptoms of celiac disease. But, upon testing, they are diagnosed with the condition.

Testing for Celiac Disease

The majority of people who have celiac disease do not know it. The screening test is a fast and simple blood test, often called a celiac panel. Individuals with positive test results should be referred to a gastroenterologist for further testing and diagnosis.

Some families are concerned that following a gluten-free diet will complicate meal planning unnecessarily for the family member with type 1 diabetes; they wonder if this is really necessary. While further research is needed, many people with celiac disease and type 1 diabetes need less insulin and have more stable glucose levels and increased energy, when following a gluten-free diet.

Gluten-Free Diet

Gluten is a protein found in grains such as wheat, rye and barley. People who have celiac disease need to avoid foods that have gluten. (Wait until your health care provider tells you that you have celiac disease before changing your diet. Following a gluten-free diet can make diagnosis more difficult). Reading labels can help you find hidden sources of wheat and gluten in foods. Foods labeled “wheat-free “ are not necessarily “gluten-free. “ Work with a dietitian to learn more about label-reading and how to integrate gluten-free foods with your diabetes meal plan. Many people with celiac disease need to take a gluten-free multivitamin or other supplements.

Many of the foods we eat every day are gluten-free, such as fresh fruits, vegetables, dairy products, unprocessed meats, natural cheeses and eggs. There also are special breads, crackers and pastas that have no gluten and taste great. Learning how to integrate your diabetes meal plan and a gluten-free diet will take some effort, but the long-term benefits are worth the effort.  Staying healthy with diabetes and celiac is absolutely within your reach.