Type 1 Diabetes and Celiac Disease EP027

Struggling to maintain control of your blood sugar? A gluten-free diet may be the answer! If you have one autoimmune disorder, you have a 30-50% greater risk of developing another, and both type 1 diabetes and celiac disease fall into that category.

As more and more research points to an enormous overlap between type 1 diabetes and celiac disease, it is in our best interests to mitigate additional risk by getting screened and/or adopting a gluten-free or Paleo diet to mitigate further risk. Today Nadine discusses the prevalence of diabetes, several research studies that explore the connection between type 1 diabetes and celiac disease, and the potential risks for type 1 diabetics who are undiagnosed celiac patients.

Listen and learn how your diet may be affecting your blood sugar and why going gluten-free could improve your health and quality of life!

What's Discussed:

The prevalence of diabetes

• By 2050, half the population will have diabetes
• According to CDC, 29.1 million have diabetes
• One out of four don't know they are diabetic
• 18,000 young people diagnosed from 2008-2009

The difference between type 1 and type 2 diabetes

• Minimize risk for type 2 through diet and exercise
• Type 1 is autoimmune disorder, don't produce enough insulin to break down sugar

Symptoms of type 1 diabetes

• Extreme thirst
• Urgency to urinate frequently
• Fatigue
• Weakness

The enormous genetic overlap between type 1 diabetes and celiac disease

• Scottish study found 94% of type 1 diabetics were HLA-DQ2 or HLA-DQ8 gene carriers
• 100% overlap if include HLA-DQ2.2
• Prevalence of celiac disease among type 1 diabetics is 20% higher than general population

The importance of testing all type 1 diabetics for celiac disease annually

• Can develop celiac disease at any age

The consequences of undiagnosed celiac disease in children with type 1 diabetes

• Short stature
• Failure to thrive
• Early onset osteopenia, osteoporosis
• Easily broken or rubbery bones
• Difficulty maintaining glycemic control (low blood sugar, spikes)
• Anemia

The decreased quality of life for type 1 diabetics who are undiagnosed celiac

• Development of infections
• Difficulty with blood sugar maintenance

Research studies re: the percentages of type 1 diabetics who also have celiac disease

• Iraq – 11.2%
• Mexican participants – 5.9%
• Denmark – 12.3%

Nadine's anecdotal evidence of the overlap

• Volunteers at community outreach clinic
• Young man struggling to control blood sugar
• Nadine recommended gluten-free diet
• Improved health and quality of life

Health risks associated with an inability to control blood sugar

• Blindness
• Kidney failure
• Amputation of extremities
• Difficulty healing wounds
• Heart attacks
• Strokes

Why carb counting doesn't control blood sugar

• Carbs with little/no nutrient value cause spikes in blood sugar

The diet Nadine recommends for type 1 diabetics

• Variation of Paleo diet
• Nutrient dense foods
• Meat and fish
• Eggs
• Fruits and vegetables
• Nuts and seeds

The benefits of a gluten-free diet for type 1 diabetics

• Weight easier to control
• Immune system works better
• Tighter control on blood sugar

The lack of uniformity in screening guidelines

Additional autoimmune diseases that may be avoided with a gluten-free diet

• Multiple sclerosis
• Lupus
• Sjögren's
• Scleroderma
• Autoimmune thyroiditis
• Graves' disease
• Hashimoto's
• Vitiligo
• Raynaud's

Potential triggers for autoimmune disorders

• Gluten
• Change in microbiome
• Stress to body (i.e.: cold, food poisoning, travel)

Treatments for small intestinal bacterial overgrowth

• Low FODMAPs or specific carb diet
• Rifaximin (antibiotic)

The dangers of maintaining high blood sugar

• Damage to kidneys, eyes, capillaries, fingers and toes
• Neuropathy
• Gastroparesis

The long history of a connection between type 1 diabetes and celiac disease

The need for information re: the connection in diabetic education services

Resources:

"Type 1 Diabetes and Celiac Disease: The Effects of Gluten Free Diet on Metabolic Control" in the World Journal of Diabetes

"Co-occurrence of Type 1 Diabetes Mellitus and Celiac Disease" in the World Journal of Diabetes

"Screening for Coeliac Disease in Adult Patients with Type 1 Diabetes Mellitus: Myths, Facts and Controversy in Diabetology & Metabolic Syndrome

"The Prevalence of Coeliac Disease in Libyan Children with Type 1 Diabetes Mellitus" in Diabetes Metabolism Research and Reviews

"Type 1 and Type 2 Diabetes in Celiac Disease: Prevalence and Effect on Clinical and Histological Presentation" in BMC Gastroenterology

"Coexistence of Coeliac Disease and Type 1 Diabetes" in Przeglad Gastroenterologiczny

"Screening for Celiac Disease in Type 1 Diabetes: A Systematic Review" in AAP News and Journals

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'Your Skin on Gluten' on YouTube

Books by Nadine:

Dough Nation: A Nurse's Memoir of Celiac Disease from Missed Diagnosis to Food and Health Activism