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The Autoimmune Connection between Celiac Disease and Type 1 Diabetes.

What is an autoimmune disorder?

Autoimmune disorders occur when the body’s immune system mistakenly attacks its own cells and tissues.

In type 1 diabetes, the immune system destroys the insulin-producing beta cells in the pancreas, leading to insufficient insulin production and high blood sugar levels.

In celiac disease, the immune system attacks the small intestine when gluten is ingested, causing damage to the microvilli responsible for nutrient absorption. As with type 1 diabetes, celiac disease can lead to malabsorption of calories and nutrients and lead to various health concerns.

Studies have shown that individuals with type 1 diabetes are at a higher risk of developing celiac disease.

Approximately 5-10% of people with type 1 diabetes also have celiac disease, compared to only about 1% of the general population. Research has identified several genes, such as HLA-DQ2 and HLA-DQ8, that are associated with an increased risk of developing both type 1 diabetes and celiac disease. These genes are part of the human leukocyte antigen (HLA) complex, which plays a crucial role in the immune system by helping the body distinguish between its own proteins and foreign substances.  Although both conditions have genetic components, not everyone with these genetic factors will develop both conditions.  Other factors, including environmental triggers and lifestyle factors, may also contribute to the development of either autoimmune disorder.

celiac disease and diabetes

Symptoms of celiac disease can vary greatly among individuals and may present differently before and after diagnosis.

Common signs and symptoms of Celiac Disease include:

Before DiagnosisAfter Diagnosis with Gluten Free Diet
Digestive issues like abdominal pain, bloating, and diarrheaImproved digestive symptoms
Fatigue and weaknessIncreased energy levels
Unintentional weight lossHealthy weight gain/maintenance (if previously underweight)
AnemiaResolution of anemia
Joint pain and stiffnessImproved joint function

It is noteworthy that some people with celiac disease may not exhibit any noticeable symptoms. This is known as “silent” or “latent” celiac disease.

How do you treat Celiac Disease?

The only treatment for celiac disease is a strict gluten-free diet. This means avoiding all foods and products containing wheat, rye, barley, and foods that may be contaminated or derived from them. By adhering to a gluten-free diet, individuals with celiac disease can prevent damage to their small intestine, allowing it to heal and function properly.

Over the past few years, navigating a gluten-free lifestyle has become a bit easier than it previously was as there are more gluten-free products and menu items.

Some helpful resources about Celiac Disease can be found here:

Eating Out with Celiac Disease

It can still be quite challenging at times especially when eating out at restaurants or eating with family and friends. A few tips might help:

  • Looking at menus online or calling a restaurant ahead of time can help mitigate concerns about eating certain meals outside of the house.
  • Let family and friends know about your dietary restriction and consider offering to bring a gluten-free dish to an event that everyone else might also enjoy.

Gluten contamination can occur during meal preparation even if the chef is mindful of preparing a gluten-free meal.

  • Cutting boards and other surfaces along with knives and utensils should be separated to avoid cross-contamination.
  • When eating out, it is not unusual to ask about meal preparation areas to learn if the kitchen is careful about cross-contamination.

Research advances are being made each year on finding an immunotherapy treatment for both celiac disease and type 1 diabetes. However, until there is a cure for type 1 diabetes or celiac disease, comprehensive education and careful preparation can help ease the burden of these diseases and help you take part in all the activities and events you enjoy.

If you are navigating life with type 1 diabetes and celiac, the educators at Integrated Diabetes may be a good resource. While it takes a lot to navigate both of these, one can certainly have an impact on the other. We have helped many people to adapt to a well-balanced intake without gluten while also assisting with diabetes management along the way. Let us know how we can help!

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