Gluten and Diabetes: Is There a Connection?

We investigate the validity of gluten-free benefits and the relationship between celiac disease and type 1 diabetes.


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Illustrated by Katy Dockrill

Are You Thinking About Eating Gluten-Free? 

Although many people continue to buy gluten-free foods at grocery stores and restaurants, it appears the gluten-free trend is waning for those looking to lose weight or gain energy, according to Packaged Facts, a market research company. For those who have to restrict gluten for medical reasons, such as managing celiac disease, gluten-free foods are necessary.

A key treatment for those with celiac disease, a recognized and diagnosable medical disorder, is to avoid gluten. But some celebrities and popular diet books have demonized gluten, elevating gluten-free diets to the mainstream. This exposure has led people with no medical reasons to attempt to eliminate gluten from their diets. “It’s caused a bit of hysteria,” says Pam Cureton, a registered dietitian at the Center for Celiac Research in Baltimore.

Some people incorrectly associate a gluten-free diet as synonymous with choosing to restrict the amount of carbohydrate they eat. Consumers see the gluten-free label on packaging and assume it must be better. Often, however, the gluten-free food is lower in nutrients and higher in added sugars, saturated fat, and sodium, making it a less healthy choice for most people—especially for those with diabetes.

Celiac Disease and Gluten Intolerance: What’s the Difference?

Celiac disease, a chronic autoimmune intestinal disorder, affects about 1 percent of the general population. It’s about 8 percent more common among people with type 1 diabetes, according to the Celiac Disease Foundation. Celiac disease is characterized by intestinal damage, nutrient deficiencies, joint pain, severe fatigue, weakness, and infertility. Some people, however, have no obvious symptoms when they are diagnosed.

Gluten sensitivity is more common than celiac disease. “It affects about 6 percent of the population,” Cureton says. These individuals do not have intestinal damage, so they will not suffer nutritional deficiencies, she says. However, a gluten-free diet is required to manage their symptoms, which may include joint pain, debilitating lethargy, gas, bloating, diarrhea, and brain fog. The only current treatment for both celiac disease and gluten sensitivity is a strict, lifelong gluten-free eating plan.

The Gluten and Diabetes Connection

Celiac disease and type 1 diabetes are autoimmune diseases, and research shows they may have a similar genetic basis. It is recommended that a person with type 1 diabetes be fully tested for celiac disease and gluten sensitivity prior to starting a gluten-free diet.

Diagnosing celiac disease requires an intestinal biopsy to see how gluten affects the intestine. Thus, regular gluten ingestion is necessary for accurate results. If celiac disease is ruled out through testing, gluten sensitivity is evaluated by tracking symptoms while removing and adding gluten back into the diet.

Celiac disease is not more common among people with type 2 diabetes than in the general population. Type 2 diabetes is not autoimmune in nature, and to date, there has not been a connection between type 2 and gluten intolerance.

The American Diabetes Association recommends screening children for celiac disease shortly after the diagnosis of type 1 diabetes. Unexplained nutrient deficiencies and poor blood glucose control might be signs to have evaluated. Celiac disease damages the intestine and affects nutrient absorption, sometimes without causing symptoms. Erratic nutrient absorption can cause unstable blood glucose and frequent low blood glucose levels. If you have these symptoms, talk to your primary care or diabetes care provider about being tested for celiac disease.

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