Type 1 diabetes and celiac disease: What's the connection?

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Julie Cunningham, MPH, RDN, CDCES, IBCLC

Sometimes in life, things that don't seem related are actually connected, like type 1 diabetes and celiac disease. You might not know it, but they're both autoimmune disorders that cause the body's immune system to attack its own tissues. An overactive immune system may sound like a good thing at first, but when your body can't tell the difference between a virus that needs to be taken out and your own healthy cells, your health can suffer!

If you have type 1 diabetes (T1D), you're at a higher risk of developing celiac disease than the average person. Less than 1% of the general population has celiac disease, but approximately 6% of people with T1D are diagnosed with the condition, according to the Celiac Disease Foundation.

Here's what you need to know about the signs and symptoms of celiac disease and how it's treated, as well as actionable tips for simultaneously managing type 1 diabetes and celiac disease.

What is celiac disease?

Celiac disease is a disease of the small intestine and can be developed at any age. People with celiac disease can't tolerate a protein called gluten. When they eat gluten, their immune systems react by destroying tiny finger-like projections inside their small intestines called "villi."

Villi exist to absorb nutrients; once they become damaged or destroyed, people with celiac disease are unable to get nutrients from the foods they eat. The inability to absorb nutrients leads to numerous painful conditions.

Signs and symptoms of celiac disease

People with celiac disease may experience a variety of symptoms, including the ones listed below:

  • Abdominal pain/bloating
  • Diarrhea
  • Iron-deficiency anemia
  • Fatigue
  • Bone or joint pain
  • Arthritis
  • Osteoporosis or osteopenia
  • Depression or anxiety
  • Liver problems
  • Seizures
  • Peripheral neuropathy
  • Canker sores inside the mouth
  • Rash
  • Irregular menstrual periods
  • Infertility

Screening and diagnosis of celiac disease if you have T1D

Because of the higher prevalence of celiac disease in people with T1D, the Celiac Disease Foundation recommends that anyone with T1D be screened for celiac disease.

The simplest and most common way to screen for celiac disease is with a blood test called the tissue transglutaminase IgA antibody test, KidsHealth explained. This test measures the antibodies your body produces to attack your intestinal villi — those little "fingers" that absorb nutrients — when gluten is present in your gut.

In order for this screening test to work, you must be eating a diet that contains gluten. If you've been gluten-free for several days before the test, there will be no antibodies circulating in your bloodstream, and the test results won't be accurate.

The tissue transglutaminase IgA antibody test is a screening test. If your screening test comes back positive, the only way to get a definitive diagnosis is to have a biopsy done on your small intestine. This involves a procedure called an endoscopy, which allows your doctor to take a close-up took at what's happening in your gut.

Treatment of celiac disease

If your celiac disease is severe, your doctor may prescribe steroid medications to help heal your gut. Researchers are working on new medications for celiac disease, but right now, a gluten-free diet is the primary treatment.

People with celiac disease need to avoid all gluten, which is found in barley, rye, and wheat as well as in products made from those grains. However, this is often easier said than done. Millions of products on supermarket shelves contain these items, and many have long lists of ingredients that can be hard to decipher. Additionally, because oats and wheat are sometimes processed using the same equipment, you'll need to look for oat products labeled as "gluten-free."

The National Institutes of Health is a good starting point for information about the gluten-free diet, and the Celiac Disease Foundation has several week-long meal plans you can use, including a gluten-free diabetes meal plan.

Connecting with a registered dietitian nutritionist, which you can find through the Academy of Nutrition and Dietetics, can help you better understand the condition and its connection to T1D. These food and nutrition experts can assist you with learning to manage a gluten-free diet while navigating blood sugar management at the same time. This is true for people both with and without a formal diagnosis of celiac disease.

Considering a celiac disease screening test

Just like untreated diabetes, untreated celiac disease can lead to long-term health problems. But there's good news: According to the Celiac Disease Foundation, numerous studies are underway to assess the effectiveness of new medications on celiac disease. If you have T1D, consider asking your doctor for the tissue transglutaminase IgA antibody test — it's better to get screened than to have celiac disease and not know about it.

If you do have celiac disease or experience symptoms, consult your registered dietitian nutritionist so you can learn how to follow a gluten-free diet and avoid damage to your small intestine. You're already a pro at watching what you eat, so you'll be an expert at following a gluten-free diet in no time.

Did you know there are talking blood glucose meters that can help make daily diabetes management easier and more convenient? Take a look at the No Coding Talking Meter offered by Embrace — it "speaks" English and Spanish. Plus, you can save your fingertips by checking your blood sugar using your forearms or palms!

Another way to reduce the inconvenience (and pain) of managing your blood sugars while dealing with celiac disease is through the use of continuous glucose monitoring (CGM) technology, which tracks your levels and shows trends that can help you anticipate your needs. Curious to learn more about CGMs and how they may help you manage your T1D while living a healthy, full life? Reach out to Edgepark for more information.

Julie Cunningham, MPH, RDN, CDCES, IBCLC

Julie Cunningham is a Registered Dietitian Nutritionist and a Certified Diabetes Care and Education Specialist. Julie provides online nutrition programs for people who want to end their struggle with diabetes. She can be found at juliecunninghamrd.com and at TameType2.

FB: https://www.facebook.com/juliecnutr/ LinkedIn: https://www.linkedin.com/in/julie-cunningham-a042092a/ Insta: https://www.instagram.com/juliecunninghamrd/

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