T1D & Celiac Disease


Note: This is part of our library of resources on Food. Learn more about dietary recommendations from nutritionists and foodies alike on our Food page!

Celiac disease is a genetic autoimmune disease, not a food allergy, which causes damage to the small intestine and interferes with the absorption of nutrients, when gluten is ingested.  The body, in effect, attacks itself when a person with celiac consumes gluten, found in barley, rye and wheat, damaging the lining of the intestine.  In some cases, stressful events can trigger the onset of the disease and left untreated, celiac disease can lead to additional serious health problems, such as cancer, osteoporosis, thyroid disease and other autoimmune diseases.

A wide variety of symptoms are associated with celiac, but check with your doctor if you have T1D and develop any of the following more common symptoms:

  • abdominal pain and bloating
  • chronic diarrhea
  • vomiting
  • unusually unstable blood glucose levels
  • weight loss, fatigue, irritability
  • bruising easily
  • itchy skin rash
  • growth problems (in children)
  • loss of bone density or anemia (in adults)

While only about 1% of the US population (one out of every 133 Americans) has celiac disease, an estimated 10% of people living with T1D also have celiac disease. It is important to keep getting screened periodically, even for those who have previously tested negative. Celiac can develop at any age, across gender and race. A simple antibody blood test is typically the first step and if celiac is suspected, a small intestinal biopsy is performed for confirmation.

Like T1D, celiac disease has no cure, however, the treatment is straightforward: adopting a gluten-free diet. Symptoms will diminish and the villi in the lining of the intestine will heal, more quickly in children, but strict adherence to a gluten-free lifestyle is imperative to avoid additional complications.

Learn more about celiac here.

Going Gluten-Free

The first step after being diagnosed with celiac is to consider meeting with a dietitian who can help transition your current diabetes meal plan to also fit your new needs. The dietitian will help assess your diet knowledge and needs, provide gluten-free substitutes and diet education, while monitoring and assessing results. As gluten-free diets are becoming increasingly popular, finding gluten-free options at grocery stores and restaurants is easier now than ever. A word of caution, however: because gluten-free foods are sometimes made with highly refined starches they tend to raise blood sugar more than foods containing gluten. Make sure to examine labels closely and look for less refined products!

Check out this list of where to shop for the best gluten-free products.

When dining out be certain to let your server know about your dietary needs ahead of time and always double check your order for cross-contamination.  For example, french fries or breakfast potatoes are a gluten free food but some restaurants brush them with flour. When in doubt double check and you may be surprised how accommodating some restaurants will be.

A great website/app for locating restaurants with options is Find Me Gluten Free – with over 2 million community members sourcing and rating locations all over the globe.

Gluten-free Cooking

Long gone are the days of cardboard tasting gluten-free recipes. Tons of gluten-free home cooks are sharing their delicious recipes via food blogs. Some gluten-free options are available for cooking, including:

  • potatoes
  • brown/white/wild rice
  • corn
  • quinoa
  • coconut flour
  • almond meal flour

Most importantly, celiac won’t keep you from enjoying your favorite foods. You just might have to be more creative with your ingredients! For more inspiration, check out this food blog created specifically for people living with T1D and celiac.

Read The Gluten-free Diet — Fad or Necessity by Carly Crompton and No Grain, No Gluten — No Problem by Katie Coleman.