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Diabetes and Celiac Disease

By Lara Rondinelli, RD, LDN, CDE

I've been asked by a few patients, "Do you have diabetes? If you don't have it, how could you possibly know how it feels and why should you tell me what to eat?" My response has been that I don't know how it feels to have diabetes, but I have the knowledge and the desire to help people eat and live healthier to best control their diabetes. My answer was always accepted by these people, who were probably just angry with their diagnosis.

Well, in the past couple of months, I've definitely gotten more familiar with being a patient versus being a health care provider. I didn't get diagnosed with diabetes, but I did get diagnosed with celiac disease. Celiac disease is an autoimmune disorder triggered by gluten, a protein found in certain grains, which damages the small intestines and decreases its ability to absorb nutrients. People with type 1 diabetes, as well as those with other autoimmune conditions such as thyroid disease, are more at risk for celiac disease. It is estimated that 8-10% of people with type 1 diabetes also have celiac disease, with the diabetes diagnosis usually coming first1. Celiac disease is extremely underdiagnosed in the United States. Common symptoms include gas, bloating, diarrhea, weight loss, and fatigue, but some people do not experience any of the gastrointestinal symptoms. A delay in diagnosis of celiac disease can increase the chance of developing other autoimmune diseases, along with increasing risk of osteoporosis, anemia, peripheral neuropathies, and some cancers. If you have type 1 diabetes and have any of these symptoms listed above, it is probably best to discuss this with your doctor. Celiac disease is diagnosed by a blood test that measures specific antibodies in your blood and if those are positive, then an intestinal biopsy is conducted to examine the small intestine and determine if there has been any damage.