Type 1 Diabetes and Celiac Disease – The Strange Overlap and What You Need to Know

It can be disheartening to learn you have one autoimmune disorder, but having two or more can be crushing. The combined diseases pose more health risks and present far more significant challenges. But rather than getting weighed down by the why, it’s best to plow ahead with the facts and uncover the best way to stay ahead of the diseases.

Read on to discover ways to cope mentally and physically when you have dual diagnoses. Taking good care of your health means caring for yourself in all forms, and the best defense is knowledge.

Is there a connection between Type 1 Diabetes and Celiac Disease?

The most affirmative answer is yes. According to the University of Chicago Medicine, the link between type 1 and celiac disease was established in the 1960s by researchers at the academic medical health institute. The National Institutes of Health concluded the two autoimmune disorders have a common genetic background while sharing similar symptoms and risk factors.

Also, the Juvenile Diabetes Research Foundation states, “People with type 1 diabetes (T1D) are at an increased risk of developing other autoimmune disorders, the most common being celiac disease.” The organization found that more than 10% of people with type 1 diabetes also have celiac disease.

Co-managing celiac disease (CD) and type 1 diabetes can be an arduous lifestyle change. First, let’s explore the symptoms and risks of each, how to treat them, and finally, the best ways to conquer these beasts to lead healthy, productive lives.

Dual Diagnosis: Type 1 Diabetes and Celiac Disease Symptoms

What are the Symptoms of TID?

With the autoimmune disease T1D, the pancreas stops producing insulin, the hormone needed to move glucose from our bloodstream to the body’s cells to make energy. The goal for T1D patients is to keep blood sugars as close to normal as possible.

T1D Individuals may feel extremely thirsty, hungry, and lethargic while urinating more frequently and experiencing weight loss. If experiencing a low blood sugar episode as a result of too much insulin in the system, patients experience dizziness, shakiness, hunger, abdominal pain, sweating and irregular heartbeat.

Check here for a more complete list of symptoms.

What are Celiac Disease Symptoms?

Celiac disease is more complicated to diagnose. With over 200 symptoms that can occur, it is a vastly underdiagnosed disorder. Symptoms can appear at any age, from infancy into senior adulthood. Also, CD affects everyone a little differently and can be asymptomatic.  

With type 1 diabetes, the body attacks the insulin-producing beta cells in the pancreas; when celiac patients consume gluten, their immune system attacks the lining of the small intestine.

Most signs occur in the digestive system, and like type 1 diabetes, the causes are still unclear. Some sources claim stress can trigger celiac disease or a viral infection, as in T1D. 

According to the Celiac Disease Foundation, symptoms include the following but are not limited to:

• Gastrointestinal bloating, gas, abdominal pains as well as constipation, diarrhea, nausea, and vomiting
• Fatigue
• Depression and anxiety
• Iron deficiency or anemia
• An itchy, blistery skin rash
• Joint pain
• For females – missed periods
• Mouth ulcers and canker sores
• Osteoporosis and osteomalacia (softening of the bones)
• Peripheral neuropathy (weakness, pain, or numbness in the hands and feet)
• Weight loss
• Cognitive impairment, headaches, or migraines

The Risks Associated with Type 1 Diabetes and Celiac

The Risks of Untreated Type 1 Diabetes

If a person with type 1 diabetes does not control their blood sugar, constant high blood glucose levels can lead to:

• Heart disease and stroke
• Foot and circulation problems
• Vision problems and blindness
• Neuropathy (pain and loss of feeling, nerve damage)
• Kidney problems
• Gum Disease
• Diabetes ketoacidosis (DKA) is caused by an overload of ketones in the bloodstream as a result of consistently high blood sugar levels. This condition can lead to diabetic coma or death if left untreated.

The Risk Factors of Untreated Celiac Disease

Celiac disease can lead to serious long-term, even life-threatening health complications if left untreated. The most severe include an increased risk of developing certain cancers. Other concerns are that CD can overlap with autoimmune disorders like type 1 diabetes and multiple sclerosis (MS).

Early onset osteoporosis (bone loss), anemia, infertility and miscarriage are also associated with CD, as well as nephropathy, retinopathy, nervous system disorders, and neurological conditions like epilepsy and migraines. There may also be an increased risk of anxiety and depression. Check here for a complete list of symptoms.

Silent Celiac Disease

Asymptomatic celiac disease, or the silent variety, is a condition where patients don’t experience any symptoms but still undergo risks and complications. Most type 1 diabetes individuals are asymptomatic with celiac, making testing crucial.

First-degree relations of individuals with celiac disease should be screened since there is a one in 10 risk of developing the disease.

Type 1 Diabetes and Celiac Disease Screening

If you’re concerned you may have either T1D or celiac disease, testing for both requires a simple blood test. A positive celiac screening will show specific antibodies with elevated gluten levels. In addition to the celiac blood test, your doctor can perform a tissue biopsy from the small intestine via endoscopy to confirm the diagnosis.

Type 1 Diabetes and Celiac Disease Solutions

As important as controlling blood sugar is for type 1 diabetes, monitoring your diet is equally vital for celiac disease. And as insulin therapy is the only treatment for type 1 diabetes, following a strict gluten-free diet is the only treatment for celiac disease. Studies show a strict gluten-free diet reduces intestinal issues like bloating, flatulence, and acid reflux.

There is no cure for CD, meaning the individual’s diet must avoid all foods and beverages with gluten, a protein found in wheat, rye, barley, and triticale—for life.

The good news is that consuming a gluten-free diet is much easier today than five or ten years ago. Most restaurants and grocery stores offer gluten-free options, and the quality of food is getting better all the time. You can find restaurants near you at  FindMeGlutenFree.com and can download the free app on your cell phone.

What Should a T1D with Celiac Eat?

T1Ds with celiac disease should eat a gluten-free diet consisting of whole foods and processed gluten-free foods like bread, chips, rice and pasta. A gluten-free diet allows the impaired small intestine to heal.

Unfortunately, even ingesting a small amount of breadcrumbs can trigger intestine damage, so taking the diet seriously is essential. In addition to foods like pizza and baked goods, gluten can be found in soy sauce, beef jerky, ice cream and even beauty products and certain medications.

Gluten Foods to Avoid

Gluten, which acts as a glue to hold food together, is unfortunately found in many foods, even those you wouldn’t expect. The big three are wheat, barley and rye.

The Big Three Glutens: Wheat, Barley and Rye Can Be Found in the Following:

• Bread
• Baked goods
• Soups
• Pasta
• Cereals
• Sauces
• Roux
• Salad dressings
• Brewer’s yeast
• Beer
• Malt

Some people incorrectly think a gluten-free diet means a carbohydrate-free or keto diet, which is not the case. Foods that contain carbs, like rice, potatoes and beans, don’t contain gluten. Also, some products that don’t contain gluten may have been processed in a facility with gluten production, so it’s best to stick with the gluten-free label to be safe. Moreover, always check the packages’ ingredients to be certain and carefully read labels to check for wheat, barley and rye, sometimes found in artificial colors and seasonings.  

Seriously, What the Heck Can I Eat?

It may be a pain to check, but on the bright side, everything with gluten probably has a gluten-free variety. This includes pizza, bread, baked goods, ice cream and even beer.

You may have to go through a try/fail system to find the best brands, but it will ultimately be worth it. Furthermore, when baking, you can substitute oak, buckwheat, quinoa or other gluten-free alternatives for wheat flour. These free whole grains are naturally gluten free.

Gluten free foods and free whole grains include:

• Fruits
• Vegetables
• Beef
• Poultry
• Fish
• Nuts
• Eggs 

Interesting Fact: Some people don’t have celiac disease or type 1 diabetes and simply have celiac gluten sensitivity or gluten intolerance.

Gluten Sensitivity

Some diabetes mellitus patients and other individuals with autoimmune conditions may have gluten intolerance, which is mistakenly called celiac gluten sensitivity. However, gluten sensitivity and celiac are two different conditions. While both involve gastrointestinal issues with gluten and can cause the same symptoms as celiac disease, such as abdominal pain and lethargy, gluten sensitivity does not damage the small intestines like celiac disease does.

There is also no celiac gluten sensitivity test. People who suspect gluten intolerance or celiac disease need to see a gastroenterologist to determine their risk for either condition.

The Silver Lining of a Celiac Disease Diagnosis

Eating gluten-free is trending big with the general population. All the cool kids are doing it; half of Hollywood celebrities eat gluten-free. And if you don’t give two cents what they do in Tinsel Town, maybe ruminate on the fact that you’ll live longer because gluten is not good for us. Besides, Johns Hopkins Medicine said that people who switch to a gluten-free diet often lose weight by cutting out processed foods and refined carbohydrates.

In addition to avoiding the much-dreaded complications, patients reportedly felt much better about successfully managing gluten-free diets. T1Ds may notice a change in their blood glucose level control after adhering to the food restrictions and may need more or less insulin, which is why it’s essential to work with your healthcare provider during the process.

Most importantly, the National Institutes of Health reports that gluten-free diets have been known to decrease hypoglycemic episodes in type 1 diabetes. From a broader perspective, one could argue that a gluten-free diet is an all-around healthier lifestyle.

Other Sources to Check Out:

• Celiac Disease Foundation
• JDRF
• FindMeGlutenFree.com
• Beyond Celiac

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