New Research Links Type 1 Diabetes with Celiac Disease

Doctors & PatientCeliac disease and Type 1 diabetes are both autoimmune disorders, so I suppose it’s not terribly shocking that there would be a large overlap between the two populations. However, the study recently published in the Italian Journal of Pediatrics is fascinating for the insights it has found about those who have both celiac disease and diabetes.

The study did not examine new patients, but rather combed through existing studies to pool as much data as possible. They found a number of interesting statistics, with implications for diagnosing and treating both medical conditions. More specifically, the researchers found that within the data they surveyed:

  • Although the general population has a rate of celiac disease of only 0.5 percent, the rate for people with Type 1 Diabetes (hereafter T1D) is beween 4.4 and 11.1 percent. Both conditions share a common genetic heritage.
  • Patients who have both diseases tend to develop diabetes at a younger age than those who “only” have diabetes. Although diabetes is often diagnosed first and celiac disease second (because of screenings at the time of T1D diagnosis), some medical professionals speculate that silent or mildly symptomatic celiac disease may be triggering diabetes and/or other thyroid disorders. Doctors do not know if an early adaptation of a gluten-free diet could help to prevent diabetes or other thyroid disorders from being activated in susceptible patients.
  • Although celiac disease is far, far, far more common amongst people with T1D, these celiac patients often present with so-called atypical symptoms. Fewer than ten percent of children with Type 1 Diabetes and celiac disease have so-called gastrointestinal presentation, eg malnutrition, diarrhea, constipation, vomiting, abdominal pain, etc.
  • Compliance to the gluten-free diet amongst this overlapping population tends to be good when classic celiac symptoms appear and poor when the celiac disease is silent or low-symptom. Given that many people with both conditions have atypical presentation of celiac disease, this is quite concerning. Data from the study indicates that in Australia compliance with the gluten-free diet may be as low as 25-30%, and in Italy it may be as low as 59%.
  • Even in patients who are symptom-free (but diagnosed with both celiac and T1D), positive changes in bone miniral density and weight gain (for malnourished children, presumably) have been found.
  • Even in patients who are testing negative for celiac antibodies, inflammation has been found in the intestines. It remains unclear whether this inflammation is gluten-related.
  • Many gluten-free alternatives to traditional gluten-containing foods (like sandwich bread) are actually higher on the glycemic index than their gluten-containing alternatives. Given the importance of avoiding blood sugar spikes for the diabetic population, this puts patients with both conditions (or their parents) in a difficult position.
  • Quality of life is generally better for those patients who are compliant with a gluten-free diet (if indeed they have both celiac disease and T1D) however many patients — especially teenagers — are not compliant.

For more information, you can check out the study on PubMed or the overview on Does anyone in your life have both celiac disease and Type 1 diabetes? If so does the data in this study ring true?

4 thoughts on “New Research Links Type 1 Diabetes with Celiac Disease”

  1. My family is swamped by both conditions. Four people in three generations of my immediate family have/had T1D, two of whom have celiac (my son and my brother). We suspect that my father also had celiac, though in addition to T1D, he was diagnosed with thyroid issues but not celiac. We also have at least five cases of celiac in my extended family. I think we’d make an interesting case study.
    The numbers don’t surprise me as I’d heard long ago that 1 in 20 diabetics had celiac. The earlier age doesn’t come as a surprise either. My brother was dx’d at 10 with diabetes (years later with celiac), while my son was 4 when we got the double dx. My nonceliac brother was 14 and dad in his 20s. My son seemed to be asymptomatic for celiac as well.
    As for the gf food alternatives, it is a thorn in our sides. We’re constantly looking for breads and pastas with the lowest amount of carbs and the highest amount of fiber and trying to get the insulin dosing just right to avoid/minimize spikes. But I would argue that because of all the package reading we do for ingredients AND nutritional value puts us in a better position than many in the general population. For instance, I might not have paid any attention to whether an applesauce was sweetened before the diabetes dx, but we’re all better off with the unsweetened variety as a result of our increased attention.

  2. I too have both diseases. I was diagnosed with Type 1 Diabetes at 23, 10 years later I was diagnosed with Celiac Disease. I probably had celiac disease for years before I was diagnosed but didn’t know till I received some unusual bloodwork. I don’t eat a lot of bread anymore due to the high carb content. But when I do want bread I buy the Rudi’s gf bread, it doesn’t seem to affect my blood sugar. I tend to stick with brown rice products, corn & potatoes. If you’re looking for a low carb bread, try making bread with coconut flout, it’s a high fiber low carb bread and is actually pretty good. I’ve learned to adapt to both diseases and live a healthy life. I don’t feel like I miss out on too much anymore. It does become a pain at gatherings though.

  3. I have both. I was diagnosed with Diabetes when I was 8 years old, and Celiac when I was 14. And, in accordance with the article, I happen to be asymptomatic.
    Since I have no symptoms, I’m lucky to have been diagnosed with Celiac before any permanent damage was done to my intestines. I was told I had mild damage that would heal once I started a Gluten Free diet (which I follow very strictly). My endocrinologist was aware of research that suggested a link between T1D and Celiac and so had all of her patients tested. She told me that four of her patients (including me!) had it! I’m very grateful she did that for me.

    I’m healthy and manage both diseases well. They don’t seem to interfere with each other.
    Though, once I was in a weird situation and I had low blood sugar and didn’t have any food/drink with me and the only thing I could find was a cookie! What a horrible feeling to feel like I have to damage my body in one way to save it in another way! Yuck!

  4. My daughter presented with Type 1 when she was 9 years old. My father passed away from Colon Cancer, I am gluten intolerant, along with many other food sensitivities. When I suggest my theory of the gluten connection to the Diabetes, the doctors and nurses just look at me like I am a nutball…they have tested my daughter for celiac, but she has tested negative, which I would too. These theories are hard to prove. I just wish the medical professionals would give it some credence. Lives are at risk! I also try to educate the dentists, hygienists regarding ulcers on the tongue and gluten intolerance. It really surprises me that there is so much ignorance on the subject!

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