If you have type 1 diabetes or you have a child with this type of diabetes, it’s important to know about the link between diabetes and another autoimmune condition: Celiac disease. These two conditions may show up together. Understanding how they are connected can help you or your child stay healthier and manage symptoms better.
What is celiac disease?
Celiac disease is a long-term autoimmune condition. If you have celiac disease, eating food that contains gluten triggers your immune system to attack the lining of your small intestine.
“Gluten is a protein found in wheat, barley and rye,” said Rekha Kumari Agarwal, MD, an endocrinologist with Banner Health. Lots of common foods — like bread, pasta and baked goods — contain gluten.
Over time, the damage to the small intestine can lead to problems with absorbing nutrients. This may cause symptoms like:
- Fatigue
- Stomach pain
- Weight loss
- Skin issues
- Feeling cold
- Diarrhea
- Anemia
- Weak bones
- Delayed growth in children
The only treatment is a strict gluten-free diet.
How is celiac disease linked to diabetes?
Celiac disease and type 1 diabetes are both autoimmune conditions. In celiac disease, your immune system attacks your small intestine. In type 1 diabetes, your body attacks the cells in the pancreas that produce insulin, a hormone that helps control blood sugar levels.
Both conditions involve your immune system attacking your body’s own tissues – and they often appear together. “They share a genetic susceptibility. Up to 16% of people with type 1 diabetes have celiac disease, compared to 1% of the general population,” Dr. Agarwal said.
Both conditions are more likely if you have certain genes (HLA-DQ2 or HLA-DQ8), which health care providers can test for.
Type 2 diabetes is not strongly linked to celiac disease.
Why is screening important?
If you have type 1 diabetes, you may also have celiac disease without noticing any symptoms at first. That’s why screening is often recommended.
Your health care provider may suggest a blood test to check for celiac disease if:
- You’re newly diagnosed with type 1 diabetes
- It’s been 5 years since you were diagnosed with type 1 diabetes
- You have symptoms like frequent upset stomachs or poor blood sugar control
- A child with diabetes is not growing as expected
Catching celiac disease early can greatly help improve digestion, boost energy and make it easier to manage your diabetes. “Screening is so easy — it’s a simple blood test — so you should bring it to your provider’s attention if you think you should be screened,” Dr. Agarwal said.
How can one condition affect the other?
If you have both diabetes and celiac disease, it can be harder to control your blood sugar levels, especially if celiac disease isn’t treated. Low levels of nutrients, weight changes and inflammation may also affect how insulin works in your body.
A gluten-free diet can help you keep your blood sugar levels stable and help prevent long-term complications from both conditions. But you need to do some planning to manage both diets well.
What are tips for living with type 1 diabetes and celiac disease?
Managing these two chronic health conditions can feel overwhelming. “It can be very frustrating, because you have to follow a diabetic diet and a gluten-free diet,” Dr. Agarwal said. Here are some helpful tips:
- Work with a registered dietitian: A dietitian familiar with both diabetes and celiac disease can help you plan meals and snacks that are safe and balanced.
- Know the risks: If you eat gluten, it could trigger inflammation. Inflammation can cause insulin resistance. And celiac disease can mean you’re not absorbing carbs, which can make your blood sugar levels low.
- Read food labels closely: Look for hidden sources of gluten that could cause celiac disease flares. Check carb content to manage your blood sugar.
- Check medications for gluten: Dr. Agarwal says that medications you take for diabetes won’t have gluten in them, but other medications might. Ask your pharmacist or provider.
- Keep a journal: Dr. Agarwal recommends tracking your food and your glucose levels. That way, you can spot connections.
- Be cautious when you eat out: Always ask about cross-contamination and how food is prepared.
- Plan ahead when you’re traveling: Pack gluten-free snacks and check menus ahead of time.
- Stick to a routine: Regular meals and snacks help keep your blood sugar stable.
- Talk to your provider: You may need to adjust your insulin. “Many gluten-free products are high in carbs and low in fiber,” Dr. Agarwal said. “They could cause blood glucose spikes.”
When should you talk to your health care provider?
If you or your child has diabetes, let your care team know if you notice any of these signs:
- Stomach issues
- Unexplained fatigue or weight loss
- Bloating or diarrhea
- Skin rashes or mouth sores
- Trouble keeping blood sugar in range even though you’re following your care plan
- Poor growth in children
These could be signs of celiac disease, which can be diagnosed with a simple blood test.
The bottom line
When you’re living with type 1 diabetes, you have to pay close attention to your diet and lifestyle. If you or your child also has celiac disease, or you’re concerned about symptoms, it’s important to get tested and treated early. With the right diagnosis and a solid plan, you can stay on top of your health and feel your best.
Managing multiple chronic conditions takes a team. At Banner Health, our specialists in endocrinology, gastroenterology and nutrition work together to offer personalized care. Whether you need help managing blood sugar, adjusting your diet or navigating life with two autoimmune conditions, we’re here to support you.
To learn more about testing and treatment options for celiac disease or diabetes, schedule an appointment with an expert at Banner Health.
