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Type 1 Diabetes and Celiac Disease

Posted May 21 2013 12:00am

Today we have a guest post on Type 1 Diabetes and Celiac Disease by Jennifer Shea-Bianchi DTR, CPT, The Healthier You .

Type 1 diabetes was once referred to as juvenile diabetes because it is usually diagnosed in children.  In people with Type 1 diabetes, the body does not produce insulin.  Only 5% of people with diabetes have this form of the disease. (3)


The occurrence of celiac disease in patients with Type 1 Diabetes is documented to have a ratio 5-7 times higher than the general public. (1) Additionally, an estimated 10% of people with Type 1 diabetes also have celiac disease.


Both celiac disease and Type 1 diabetes are autoimmune diseases.  Researchers funded by the Juvenile Diabetes Research Foundation found that Type 1 diabetes and celiac disease not only share genetic causes but could have similar environmental triggers as well. (2)


Richard A. Insel, MD, Executive Vice President, Research, at JDRF, said: "These studies demonstrate that type 1 diabetes and celiac disease share far greater genetic overlap than had been appreciated, which helps explain the high prevalence of both diseases occurring simultaneously in an individual, and provide new avenues for understanding the cause and mechanisms of both diseases."(2)


There are many ongoing studies on the connection between these two diseases, but in the meantime how do we test and treat these conditions? There is controversy among the medical professionals on how this is to be done.  Both The American Diabetic Association (ADA) and the National Institute of Health (NIH) advocate screening all Type 1 Diabetes patients for celiac disease. They also urge patients with a confirmed celiac diagnosis to maintain a gluten-free diet.  On the other hand, the Canadian Diabetes Association (CDA) promotes screening Type 1 Diabetes patients for celiac but they emphasize that treatment of asymptomatic celiac disease combined with Type 1 Diabetes is controversial. (1)


How to eat both a gluten free and diabetic diet?


So what do you do if you have both Type 1 diabetes and celiac disease?


Nutrition is one of the most important pieces of the diabetes puzzle. Understanding how different foods affect your blood glucose and learning to develop solid meal plans is a crucial part of your daily routine. (3)


The good news is that the GF diet is also a diabetic friendly diet.


Many GF grains and products work well on a diabetic diet. The important components of a diabetic meal plan are foods that contain both protein and fiber; these nutrients do not raise blood sugar, and help the carbohydrates that are eaten to enter the blood stream more slowly in order to control the blood sugar.


It is very important for those who follow a gluten-free diet to count their carbs and take insulin/medications. You can stay healthy by replacing foods that have gluten with other healthy higher fiber/protein carbohydrate sources. A gluten free Mediterranean style diet works well for diabetes since it includes lean meats, nuts, fish, olive oil and lots of vegetables.


Some suggestions of GF choices that are also diabetic friendly are:

  • Brown rice/Brown rice flour
  • Brown rice pasta
  • Wild rice
  • Quinoa
  • Amaranth
  • Cornmeal
  • Lean beef, chicken, fish
  • Tofu (gf)
  • Vegetables
  • Nuts and seeds (flax, chia)
  • Oatmeal
  • Berries
  • Eggs
  • Beans
  • Olive oil
  • Cheese


Foods to avoid or use sparingly on a diabetic/GF diet:

  • White rice/White rice flour
  • White rice pasta
  • Fruit in excess
  • Fruit juice
  • Gf cakes, cookies, pastries made with white flours and lots of sugar
  • Candy
  • Sodas that contain sugar
  • Salad dressing high in carbs


Being gluten free and diabetic means not only having to look at the label for gluten but also checking the carb count of those items.  Make sure you read labels carefully; the wheat bread you used to buy may have been lower in carbohydrates than the GF version you eat now. Look for crackers and snack foods that contain fiber and protein to help keep blood sugar steady throughout the day. Learning how to make baked goods with whole grain GF flours and using stevia can give you a lot more variety and freedom on a diabetic/GF diet.


 Finding a good health care provider who can help you navigate a Diabetic/GF diet is important in being able to maintain a healthy body and lifestyle through a balanced diet and exercise.


Jennifer Shea-Bianchi DTR, CPT Jennifer

The Healthier You , owner

Certified Personal Trainer

Diabetes Free America Provider

My name is Jennifer Bianchi, DTR (Dietetic Technician Registered) Nutrition Coach. My areas of specialty include weight loss, diabetes education, exercise nutrition and celiac disease. My background was not originally in nutrition until I was diagnosed with celiac disease in 1997. I was always interested in nutrition so after my diagnosis I saw this as an opportunity to further my education and help people in a way they were not being helped. I worked in clinical nutrition for 7 years then opened up my own practice called The Healthier You in 2007. Last year in 2012 I became a personal trainer so I can give my clients a well-rounded experience of both nutrition and exercise help. 



(1) Int J Pediatr Endocrinol. 2010;2010:161285. Epub 2010 Jun 23.








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