Celiac Disease and Diabetes

Written by Julia Telfer, MPH

Celiac disease is an autoimmune disorder in which people cannot tolerate gluten, a protein found in wheat, barley, and rye. When an individual with celiac disease eats foods or uses products that contain gluten, his or her immune system reacts and causes intestinal irritation, swelling, and long-term damage. Specifically, the tiny, finger-like villi that line the inside of the small intestine are damage or destroyed. In a healthy individual, these villi absorb nutrients from food and pass them through the walls of the small intestine into the blood stream. Without healthy villi, an individual can become malnourished, regardless of how much food he or she consumes.1

Who Has Celiac Disease?

Approximately one in 141 Americans has celiac disease. Celiac disease is more prevalent in people with type 1 diabetes than the general population, with 10% of children with type 1 testing positive for the antibodies that indicate celiac disease compared to 1% of children in the general population.3 Research has also suggested that type 1 diabetes may be triggered by gluten consumption.3

Although the exact cause of celiac disease is unknown, certain genetic and environmental factors can increase your risk of developing celiac disease. About 50% of people with celiac disease have a family member who also has the disease.2 Environmental factors that can trigger symptoms include pregnancy, childbirth, viral infection, surgery, and severe emotional stress.

Both type 1 diabetes and celiac disease are autoimmune diseases, and they share genetic similarities. Upon diagnosis of type 1 diabetes, the American Diabetes Association recommends screening for celiac disease.4

Symptoms of Celiac Disease

Signs and symptoms of celiac disease vary widely across individuals. Children are more likely than adults to experience digestive symptoms such as:

Adults are more likely to experience symptoms such as:

Some people have no recognizable symptoms of celiac disease, however they are still at risk for developing long-term complications and health problems impacting many of the body’s systems.

Diagnosis

Because the symptoms of celiac disease are similar to those of other conditions (such as irritable bowel syndrome, lactose intolerance, and chronic fatigue syndrome), celiac disease often goes undiagnosed. Celiac disease is diagnosed using:

If results or symptoms indicate that a patient has celiac disease, an intestinal biopsy or skin biopsy may be used to confirm the diagnosis.

Treatment

Upon diagnosis, your healthcare provider should refer you to a registered dietitian nutritionist (RDN) who has experience working with individuals who have both celiac disease and diabetes. Most people with celiac disease respond well to a gluten-free diet, experiencing significant reductions in symptoms. A dietitian can help you identify foods and products that contain gluten and can work with you to design a personalized meal plan to meet your diabetes and celiac needs.

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Diagnosing Celiac Disease