The CGM Blog
How Are Celiac Disease and Type 1 Diabetes Related?
One health challenge closely related to type 1 diabetes (T1D) is celiac disease. Because individuals living with T1D are at higher risk of developing celiac disease,1 it’s important to talk to your doctor about symptoms you or a loved one living with T1D might be experiencing.
Managing celiac disease on top of T1D is a demanding responsibility that requires your energy and attention every day. However, with supportive resources, the right tools, and guidance from your doctor, you can absolutely find a balance that works for you or your loved one, and continue to enjoy a full, active life—and some pretty delicious food, too!
What is Celiac disease?
Celiac disease is an autoimmune reaction to gluten, which is a protein found in the grains wheat, rye, barley, and triticale (a hybrid of wheat and rye).1,2 While you might think that gluten is only found in pasta, bread, and other baked goods, it’s also a common ingredient in processed and packaged foods and beer.3
When someone living with celiac disease eats gluten, their body triggers an immune response in the small intestine. This immune response damages the cells that help the body absorb other essential nutrients from food.3 If the body can’t absorb nutrients properly, it might not be getting enough energy which can lead to issues like weight loss, anemia, and slowed growth.2
Celiac disease is a genetically inherited condition, which means it runs in the family. Sometimes symptoms can be triggered when someone with a family history of celiac disease experiences challenges like emotional stress, pregnancy, surgery, or an infection.3
Celiac disease is not the same as a wheat allergy or gluten intolerance. A wheat allergy is an immune response to eating foods that contain wheat that can result in symptoms like headaches, rashes, sneezing, and anaphylaxis (swelling that leads to trouble breathing). Gluten intolerance has very similar symptoms to celiac disease—namely, having a bad reaction to eating gluten—but it doesn’t cause damage to the intestines.3 The most common symptom to look out for is recurring gastrointestinal discomfort or irritability.
What Should I Do if I Think I Have Celiac Symptoms?
If you’re living with T1D or not, it’s helpful to listen to your body and check in with yourself about how you’re feeling on a regular basis. Whenever you’re experiencing new or unexplained symptoms, you should contact your doctor to discuss them.
Every body is unique and might react differently to the autoimmune response caused by celiac disease. There are many different symptoms of celiac disease, and the only way to know if you’re experiencing it is to get tested by a doctor. A non-exhaustive list of the most common symptoms includes:3
● Recurring gastrointestinal discomfort or irritability, such as:
- Gas
- Abdominal pain, cramps, or bloating
- Indigestion and nausea
- Chronic diarrhea or constipation
● Difficulty gaining weight
● Anemia (an iron, folate, or B12 deficiency)
● Extreme weakness and fatigue
● Frequently experiencing unexplained low blood sugar (hypoglycemia)
● Developing an intense burning, itching rash (dermatitis herpetiformis)
● Canker sores in the mouth
● Anemia (an iron, folate, or B12 deficiency)
● Extreme weakness and fatigue
● Frequently experiencing unexplained low blood sugar (hypoglycemia)
● Developing an intense burning, itching rash (dermatitis herpetiformis)
● Canker sores in the mouth
Many individuals who have celiac disease don’t have any symptoms at all.3 Even if you don’t have symptoms, it’s important to get routine tests to see if you might have developed celiac disease. Celiac disease can cause issues with nutrient absorption in the intestines regardless of whether an individual experiences noticeable symptoms.7 Getting diagnosed and taking steps to eliminate gluten from your diet can help you ensure that you’re able to get all the nutrients you need from your food.
Talk to your doctor about any symptoms you might be having. If you’re living with T1D, your doctor may already be doing regular screening for celiac disease. You can speak with your doctor about getting tested or setting up routine testing. If you’re experiencing unusual symptoms that interfere with your diabetes management, such as a trend of hypoglycemia, it’s important to bring it up with your doctor to rule out celiac disease as a factor.
Celiac disease is officially diagnosed with a small intestinal biopsy.3 A biopsy is a procedure where a small sample of tissue is taken from the body so that it can be examined with a microscope.8 There are also blood tests that are used to screen for celiac disease. These types of tests detect antibodies that cause celiac disease. You still need to get a biopsy to confirm a diagnosis even if you’ve been screened with a blood test.3 Be aware that you should not stop eating gluten before you get tested because it can change the results of the tests that detect celiac disease.3
The Relationship Between Celiac and Type 1 Diabetes
Both celiac disease and T1D are autoimmune conditions, meaning the body's immune system mistakes its own healthy tissues as foreign and attacks them.1 In T1D, the body experiences an autoimmune event that destroys the cells in the pancreas that produce insulin11—a hormone that regulates sugar, or glucose, in the body.12 Similarly, for someone with Celiac’s disease, eating gluten triggers an immune response that damages the small intestine. Celiac disease and T1D share a common genetic background. This means that people living with T1D are more at risk of developing celiac disease .1
It’s important to note that because type 2 diabetes (T2D) is not an autoimmune condition, there isn’t the same linkage between T2D and celiac disease.13 People living with T2D are not at increased risk of developing celiac disease like those living with T1D are.7
Celiac Disease and Children Living with Type 1 Diabetes
About 4–9 percent of children with T1D also experience celiac disease. Children are more likely to develop celiac disease within the first ten years of living with diabetes. In 60–70 percent of these cases, kids don’t experience any symptoms. Just a few of the possible symptoms children might experience if they’re developing celiac disease include:3
● Not growing at the expected rate
● Expressing irritability and behavioural changes
● Unexplained vomiting
● Delays in hitting puberty
● Changes or abnormalities in dental enamel
● Expressing irritability and behavioural changes
● Unexplained vomiting
● Delays in hitting puberty
● Changes or abnormalities in dental enamel
If a child has a genetic predisposition for celiac disease, eating gluten may trigger it.17 In particular, consuming gluten within the first two years of life may lead to an initial peak of intolerance.8 Kids with the genetic predisposition who eat high amounts of gluten within the first five years of their life are also more likely to develop celiac disease.18
As a parent or caregiver of a child living with T1D, it’s a good idea to keep an eye on your child’s reactions to gluten and ensure that they are tested regularly for celiac disease by your doctor. If your child has been diagnosed with celiac disease, know that there are supports available to help you ensure that your child stays healthy without compromising on the experience of just being a kid. The Canadian Celiac Association has a handy workbook and plenty of resources for parents and caregivers of children living with celiac disease.
Managing Celiac Disease and Type 1 Diabetes
There is no cure for celiac disease but eliminating gluten from your diet can stop the autoimmune reaction and prevent further damage to your small intestine.21 Because of the necessary dietary changes, taking care of yourself or your child after a celiac disease diagnosis can feel overwhelming, especially having to juggle the dietary and lifestyle requirements of diabetes management with the added responsibility of maintaining a gluten-free diet. Rest assured that there are tools you can use to make managing both conditions easier and less stressful.
People living with both T1D and diagnosed celiac disease need to make sure they can continue to manage their glucose levels even though they can’t eat gluten.3 Many foods that contain wheat and other grains are a primary source of carbohydrates, which provide the body with the glucose it uses for fuel. In T1D, the body has trouble regulating glucose, so it’s important to eat foods that give the body different sources of glucose to prevent hypoglycemia, or low blood sugar.
A dietitian specializing in diabetes is a great resource for helping you build a gluten-free meal plan that works for you. They can guide you to food choices that provide the energy and nutrients you need while ensuring that you can balance your glucose levels.3 To support your glucose management, you can also use technology like continuous glucose monitoring (CGM) systems to keep an eye on how the foods you eat affect your body throughout the day.
For example, the Dexcom CGM System allows you to monitor your glucose without routine fingersticks* and view your levels in real-time on a receiver or your smart device in the palm of your hand.✝ This lets you track how different foods might be impacting your glucose levels, enabling you and your team of healthcare providers to make more informed decisions about the best gluten-free meal plan options for diabetes management.
Learn more about how a CGM system like Dexcom G7 can make it easier to keep an eye on how your diet affects your glucose levels and empowers you to take control of your diabetes management.
* If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.
✝ For a list of compatible devices, visit www.dexcom.com/compatibility.
✝ For a list of compatible devices, visit www.dexcom.com/compatibility.
1 Flores Monar GV,, et al. Association Between Type 1 Diabetes Mellitus and Celiac Disease: Autoimmune Disorders With a Shared Genetic Background. Cureus. 2022;14(3):e22912. doi:10.7759/cureus.22912.
2 Celiac disease: Symptoms and causes. Mayo Clinic. Updated September 12, 2023. https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220.
3 Celiac disease and diabetes. Diabetes Canada. Accessed December 6, 2022. https://www.diabetes.ca/managing-my-diabetes/preventing-complications/celiac-disease.
4 Celiac Disease vs. Non-Celiac Gluten Sensitivity vs. Food Allergy. Cleveland Clinic. August 30, 2022. https://health.clevelandclinic.org/gluten-sensitivity-celiac-disease-wheat-allergy-differences/.
5 Type 1 diabetes. Diabetes Canada. Accessed December 6, 2022. https://www.diabetes.ca/about-diabetes/type-1.
6 What is diabetes? Diabetes Canada. Accessed December 6, 2022. https://www.diabetes.ca/about-diabetes/what-is-diabetes.
7 Diabetes and Celiac Disease. Celiac Disease Foundation. Accessed December 6, 2022. https://celiac.org/about-celiac-disease/related-conditions/diabetes-and-celiac-disease/.
8 Sahin Y. Celiac disease in children: A review of the literature. World J Clin Pediatr. 2021;10(4):53-71. doi:10.5409/wjcp.v10.i4.53.
2 Celiac disease: Symptoms and causes. Mayo Clinic. Updated September 12, 2023. https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220.
3 Celiac disease and diabetes. Diabetes Canada. Accessed December 6, 2022. https://www.diabetes.ca/managing-my-diabetes/preventing-complications/celiac-disease.
4 Celiac Disease vs. Non-Celiac Gluten Sensitivity vs. Food Allergy. Cleveland Clinic. August 30, 2022. https://health.clevelandclinic.org/gluten-sensitivity-celiac-disease-wheat-allergy-differences/.
5 Type 1 diabetes. Diabetes Canada. Accessed December 6, 2022. https://www.diabetes.ca/about-diabetes/type-1.
6 What is diabetes? Diabetes Canada. Accessed December 6, 2022. https://www.diabetes.ca/about-diabetes/what-is-diabetes.
7 Diabetes and Celiac Disease. Celiac Disease Foundation. Accessed December 6, 2022. https://celiac.org/about-celiac-disease/related-conditions/diabetes-and-celiac-disease/.
8 Sahin Y. Celiac disease in children: A review of the literature. World J Clin Pediatr. 2021;10(4):53-71. doi:10.5409/wjcp.v10.i4.53.