Tackling Celiac in the World of Someone with Type 1 Diabetes

By: Laura B., LWDI Intern

Hello! My name is Laura B. In my free time, I enjoy riding on my brother’s boat, fishing, listening to music, walking 5ks with my mom, and spending time with my family including my dog Kelly.  I was diagnosed with T1D in April 2000 and wow has it been a long roller coaster of emotions and highs and lows since then. Having T1D for as long as I have, I have learned and grown a lot from my experiences. I am currently on a Tandem t-slim X2 pump, and I have a Dexcom sensor to monitor my blood sugars. In 2020, when my diabetes management was at its best, my world got flipped around with an additional diagnosis of Celiac Disease. Living with Celiac has taught me a lot about my body and how to listen to it to stay healthy.  I have used my time with T1D and my short time with Celiac to explore some good, healthy recipes along with some snacks to enjoy. While my diagnoses have been really hard on me over the years, I have enjoyed using them to meet new people, grow in life, and expand my understanding of food and my body.  

Type 1 Diabetes (T1D) is a chronic condition in which the pancreas produces little or no insulin.  Insulin is a hormone needed to allow sugar (glucose) to enter cells and produce energy; therefore, people with T1D must manually inject insulin.  Type 1 is usually diagnosed in children, but it can occur at any age. I was diagnosed with T1D at age three, 21 years ago. As if living with T1D was not hard enough, I was also diagnosed with Celiac Disease in 2020. Celiac Disease is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine which can affect the ability of the gut to absorb nutrients resulting in nutritional deficiencies.  Unfortunately, a person with T1D is significantly more susceptible to Celiac as well because they are both autoimmune diseases (Meadows 2014) .

There is currently no cure for T1D or for Celiac Disease, so the only thing that can be done is to manage it. For T1D that includes taking insulin and testing your blood sugar every time you eat; however, the only management for Celiac is a gluten-free diet (GFD), so the intestine can repair itself. As one could imagine, managing both of these conditions at the same time can be very difficult because they both revolve around the diet, and they require a different set of rules on what can and cannot be eaten. Having a combination diagnosis like this can be very daunting in the beginning, but it becomes second nature once you do it long enough. So what should someone with a combination diagnosis of T1D and Celiac Disease eat? The best place to start is to understand each condition separately before trying to manage the diets of these conditions at the same time. 

Being a person with T1D and Celiac Disease does not mean you cannot eat the things you love ever again; however, you will have to make adjustments. Many of the nutrition intake recommendations for T1D are consistent with the recommendations for the general public; however, there are still some slight changes because carbohydrates significantly affect the blood sugar of a person with T1D. The diet for someone with T1D should consist of carbohydrates from fruits, vegetables, whole grains, legumes (beans, peas, nuts, etc.), lean meats, and low-fat milk to have the best success with blood glucose control (Delahanty 2021). While carbohydrates should come from fruits, they should not come from fruit juice because juices contain a large amount of sugar. As a result, people with T1D should avoid sugar-sweetened beverages altogether. The diet should also be low in sodium, high in fiber, and contain high quality proteins. 

I have often encountered people who think that as a person with T1D, I should never eat any sugar.  It is much more complicated than that because your body needs sugar to function. Foods consumed get converted to sugar (glucose), regardless of the source; therefore, it is more important to know what kind of sugar you are consuming and to get it from sources that actually benefit your health.  However, it does not mean you can never ever eat a small slice of cake ever again. It is also important to realize that all people with T1D are not affected in the same way by certain foods. As a result, a T1D diet can be a bit of trial and error. Carb counting is vital to a person with diabetes. In a study done to see the impact of a low carb diet in people with T1D, it was shown that a diet with 70-90 g of carbs per day is beneficial in lowering blood sugars overall without causing health problems like hypoglycemia, etc. (Nielsen et al 2005).


Insulin improvements and technology advancements have revolutionized diabetes management, but have not eliminated the need to focus on a good diet. Counting carbs, with the help of nutrition labels, is essential to maintaining healthy glucose levels.  But there are additional factors to consider when dealing with Celiac as well. Now not only will you be looking at food labels for carb info, you will also be looking for ingredients that contain gluten. 

Diabetes distress is a real thing that occurs in people with T1D, and is often triggered by the overwhelming number of food choices to make and the sense of defeat when your glucose levels are not good.  The additional complication of Celiac can add to that overwhelming frustration, so it is important to get help when you feel too stressed about your condition or the things going on in your life. 

 Since Celiac Disease is a condition in which the individual is impacted by gluten intake, the first step in a Celiac diagnosis is to cut out gluten altogether and go on a gluten-free diet (GFD). Gluten is found in products with wheat, barley, and rye, so it is very important to stay diligent in food label and ingredient list reading (Basina 2020.). I was lucky that at the time of my diagnosis, I had just finished my undergrad in dietetics, so I knew what gluten was and how many food choices would be affected. However, I could also understand how overwhelming it could be for someone who did not know what gluten was. When I was first told of the risks of eating gluten, I fell into a puddle of tears because I love pasta, pizza, rolls, and an occasional piece of cake. It is easy to focus on what you will lose.  However, the technology and food science developments over the years have made it significantly easier for individuals with Celiac to find many replacements of these things and still enjoy them.


The best way to live a happy and healthy life with Celiac Disease is to consume foods that are naturally GF. Some of the foods in this category are fruits, vegetables, meat and poultry, fish and seafood, dairy, beans, legumes, and nuts (Celiac Disease Foundation n.d.). These are also good choices for a person with T1D. It will be hard at first to adapt and feel okay with your diagnosis, but it will get easier. It may take a lot of trial and error to find what foods you like and which ones you do not, but there are many good GF alternative foods out there worth trying. I encourage all people with Celiac to branch out and take this moment to try new things because that will be key in your journey with Celiac. One of my favorite meals for breakfast before Celiac was peanut butter and banana toast with a glass of milk, and I was afraid I would not be able to enjoy that anymore. However, I found gluten free bread and all the other ingredients are naturally GF, so I was able to continue enjoying one of my favorite breakfast treats. Look at the things you love to eat as opportunities to explore and find the GF alternatives, or replace them with healthier, naturally gluten free options. 

It can be hard enough to manage just Celiac Disease, but the factor of adding T1D on top of that can be exhausting. Foods that contain large amounts of gluten also have a lot of carbs and sugar in them, which is unhealthy for people with T1D and people with Celiac. The good thing is, there is a huge overlap between which foods are naturally GF and which foods are good to eat if you have T1D (“How Gluten Intake is Linked to Type 1 Diabetes” 2020).

Healthy choices for a person with T1D and Celiac include a lot of fruits, vegetables, fresh meat and seafood, and dairy products. As there can be many harmful side effects to not adhering to a GFD when you have Celiac Disease and many extremely harmful side effects to not taking your insulin and counting carbs correctly with T1D, it is vital that people with both of these conditions strictly monitor their food intake to keep themselves happy and healthy. Below are some recipes that I have found to be very delicious and have all GF ingredients! It is important to get help if you feel overwhelmed with the burden of having to care for yourself with 2 very tiring and time consuming conditions like T1D and Celiac Disease. I know for myself, it has been super helpful having friends, family, and a third-party to talk to when things get to be too much with my conditions. I hope you are able to find someone like that in your life to help be that rock for you. If not, I am always here to help and answer any questions you have that I can answer on this topic. It’s so important to know that you are loved and while you may be unique, you can do anything you set your mind to even if you have both Celiac Disease and T1D. Don’t let your conditions stop you from following your dreams and doing what you love, I sure know I have not. Good luck, and you got this!!

GF Green Bean Casserole: https://www.bettycrocker.com/recipes/gluten-free-green-bean-casserole-with-fried-onions/74dac433-d6db-46c1-9003-6d7a4d5c03b7

GF Tater Tot Bacon Cheeseburger Casserole: https://www.mamagourmand.com/cheeseburger-casserole/

GF oreo Truffles: https://www.whattheforkfoodblog.com/2014/12/03/gluten-free-oreo-truffles/

Eat This, Not That! GF recipes: https://www.eatthis.com/weeknight-gluten-free/


Meadows, K. (2014, January). Living gluten free with type 1 diabetes. Today’s Dietitian. Retrieved February 18, 2022, from https://www.todaysdietitian.com/newarchives/010614p34.shtml 

Delahanty, L. M. (2021, June 15). Patient education: Type 1 diabetes and diet (Beyond the Basics). UpToDate. Retrieved February 18, 2022, from https://www.uptodate.com/contents/type-1-diabetes-and-diet-beyond-the-basics 

Jørgen Vesti Nielsen, Eva Jönsson & Anette Ivarsson (2005) A Low Carbohydrate Diet in Type 1 Diabetes, Upsala Journal of Medical Sciences, 110:3, 267-273, DOI: 10.3109/2000-1967-074

Basina, M. (2020, October 7). T1D & celiac disease. Beyond Type 1. Retrieved February 18, 2022, from https://beyondtype1.org/celiac-disease/?gclid=Cj0KCQiA5aWOBhDMARIsAIXLlke3yURWVchA3SKU27oO4M0YIRPaGms6BMtECnlZallYtAuoZ55n2yoaAtZCEALw_wcB 

Meadows, K. (2014, January). Living gluten free with type 1 diabetes. Today’s Dietitian. Retrieved February 18, 2022, from https://www.todaysdietitian.com/newarchives/010614p34.shtml 

Gluten-free foods. Celiac Disease Foundation. (n.d.). Retrieved February 18, 2022, from https://celiac.org/gluten-free-living/gluten-free-foods/ 

How gluten intake is linked to type 1 diabetes. Byram Healthcare. (2020, January 15). Retrieved February 18, 2022, from https://www.byramhealthcare.com/blogs/how-gluten-intake-is-linked-to-type-1-diabetes