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Type 1 Diabetes and Gluten – the Autoimmune Connection

by Dr. Jennifer Bennett

Type 1 diabetes is an increasingly common childhood condition.  It is caused by an autoimmune reaction against beta cells, which make insulin in the pancreas.  This cell destruction leads to the inability of the pancreas to make insulin, which is responsible for controlling blood sugar levels in our body.  While little is known about what causes the immune system to attack healthy cells and cause disease, increasing evidence is linking autoimmune diseases to suspected contributing factors, such as food allergies or sensitivities.

Growing evidence is forming about the connection between the ever-growing list of autoimmune diseases, including diabetes, hashimoto’s thyroiditis, celiac disease, and rheumatoid arthritis.  We still do not know exactly why autoimmune diseases are connected, but it has been shown that diagnosis with one autoimmune disease increases a person’s risk of acquiring additional autoimmune diseases in their lifetime.  Children diagnosed with type 1 diabetes have a much higher risk of also having autoimmune thyroiditis (hashimoto’s), celiac disease, Addison disease, and other autoimmune adrenal insufficiencies.

Although many of these connections have been studied at length, one that is of primary interest is the connection between type 1 diabetes and celiac disease.  Celiac disease, an autoimmune disease triggered by eating gluten-containing foods, is present in approximately 10-15% of those diagnosed with type 1 diabetes.  Only a small percent of children with type 1 diabetes have symptoms of celiac disease, but many have elevated antibodies against gluten.

Why is this so important?  Because gluten-free diets may be helpful in reducing hypoglycemia and decrease the need for insulin in the blood.  Gluten is a protein that is found mainly in wheat, but also in many other grains as well.  Common grains that contain gluten include wheat, barley, rye, spelt, and kamut.  Gluten is also found in many processed foods as a filler or stabilizer.  To make matters more confusing, some grains, such as oats, are naturally gluten-free, but are often cross-contaminated with gluten grains during farming and processing.  When someone is diagnosed with celiac disease, strict gluten avoidance is a must, as gluten stimulates the immune system to start attacking healthy cells and causing disease.

So what does this have to do with diabetes?  Diabetics and those with celiac disease can share a similar genetic make up; this means that autoantibodies against healthy tissues may be produced from similar sources.  While there is no direct evidence that celiac disease causes type 1 diabetes or vice versa, there is some evidence that a gluten-free diet may help to reduce glycemic load, decreasing immune response and helping with controlling blood sugar.

Children with type 1 diabetes should consider being tested for celiac disease, especially if they commonly have gastrointestinal distress or symptoms.  If a child tests positive for celiac disease, a strict gluten-free diet is the best way to reduce symptoms and help decrease inflammation.

Gluten-free diets can be very challenging for someone with diabetes.  This is because a majority of processed gluten-free substitutes are high in glycemic load, because they are made from other starchy foods (such as rice or potatoes) that have a high glycemic index.  It is generally recommended that parents look for gluten-free foods made from protein sources (such as quinoa or soy) which have a lower glycemic index.  We frequently recommend a whole foods diet that consists mostly of fruits, vegetables and healthy proteins for our patients with diabetes and celiac disease.  Fiber intake also needs to be monitored with gluten-free diets, as most of the fiber in the standard American diet comes from bread and enriched wheat products.

Although the transition to a gluten-free diet can be particularly challenging for a child with diabetes, there are many helpful resources to help with the changes.  The physicians at Aria Integrative Medicine are highly trained to work with families on dietary modifications for autoimmune diseases and can be a great resource for celiac and diabetic sufferers.  If you have any questions on how to implement a gluten-free diet in your household, please consult our handout on “Going Gluten Free” or call our office to schedule an appointment with one of our physicians to discuss alternative approaches to treating diabetes.

Looking for more information on autoimmune diseases? Get our FREE ebook The 5 Foundations of Autoimmune Diseases, register for one of our FREE online webinars, or check out our blog for additional articles.

Want More Information?

Get our FREE ebook The 5 Foundations of Autoimmune Diseases, register for one of our FREE online webinars, or check out our blog for additional articles.

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