Celiac Disease & Diabetes

What is Celiac Disease?

Celiac Disease is a hereditary autoimmune intestinal disorder in which the absorptive surface of the small intestine is damaged by gluten. Gluten is the collective name given to the proteins found in:

  • Wheat,
  • Barley &
  • Rye or triticale

When an individual with Celiac Disease ingests gluten, an immune reaction is triggered causing damage to the finger-like projections, called villi in the small intestine. As a result, the body is unable to absorb nutrients from food appropriately.







Autoimmune disorders occur when the body’s immune system has a difficult time differentiating between its own, healthy cells & foreign cells (i.e. viruses) causing the body to mistakenly attack normal cells.


Celiac Disease occurs commonly in those with other autoimmune disorders such as type 1 diabetes & thyroid disease or liver disease. The connection however, is not completely understood.

  • Approximately 5-8% of people with type 1 diabetes will develop Celiac disease
  • Approximately 2-5% of people with thyroid disease will develop Celiac Disease

Celiac Disease can also run in families, both in first & second degree relatives (e.g. parents, siblings, grandparents, aunt/uncle, etc.). Therefore, screening for high risk individuals should be considered.


5-22% of people with Celiac Disease have an immediate family member who also has Celiac Disease.




The development of Celiac Disease involves a combination of genetic, environmental & immunological factors. It can present at any age & may be triggered by an infection, severe emotional stress, pregnancy, childbirth or surgery.




In order to properly diagnosis Celiac Disease, individuals MUST be consuming gluten at the time of testing.

    1. Bloodwork Screening evaluating the IgA-ttG antibody
    2. Small Intestinal Biopsy for a definitive diagnosis


There is currently no cure for Celiac Disease. The only treatment at this time is a strict gluten free diet for life.


Those with Celiac Disease need to be vigilant about hidden sources of gluten & cross contamination in food products which requires careful label reading.



Cross Contamination:

People who need to eat gluten free need to check both the ingredients in food and any cross-contamination with gluten-containing ingredients that might happen when the food is manufactured, packaged and prepared for eating. Crumbs matter when considering cross contamination!


Tips to Avoid Cross Contamination:

  • Use separate butter dishes, toasters & cutting boards used for gluten free food only
  • Ensure the space you are using to prepare gluten free food is freshly washed
  • Do gluten free baking first & have it well wrapped & stored before preparing food with regular flours
  • Thoroughly scrub any pots or utensils that are used for other foods before using to prepare gluten free foods
  • Be careful when shopping out of bulk bins as they can easily be contaminated by using the scoops in more than one bin
  • Be cautious of purchasing meat at the deli counter. Gluten free meats may be cut using the same utensils without cleaning in between as non-gluten free meats
  • Be cautious of buffets
  • Avoid foods fried in oil where non-gluten free battered foods have been fried
  • Read labels for hidden gluten in medications or cosmetics


It is recommended that people with Celiac Disease choose grains, cereals & flours that are clearly labelled “gluten free” as they are at high risk for cross contamination.





People with Celiac Disease can present with a variety of symptoms which may appear suddenly or gradually over time.


  1. Typical Symptoms:
  • Chronic diarrhea
  • Abdominal pain
  • Unexplained weight loss
  • Malabsorption (especially of iron, folic acid and/or Vitamin B12
  1. Atypical Symptoms:
  • Anemia
  • Osteoporosis
  • Extreme fatigue
  • Oral ulcers (i.e. canker sores)
  • Constipation
  • Infertility
  • Lactose intolerance
  • Bone/joint pain and/or muscle cramps
  • Itchy, blistering rash (dermatitis herpetiformis)
  • Neuropathy (inflammation of nerves)


Gluten-Containing Foods & Ingredients:


Please note that this is not an exhaustive list!


  • Wheat
    • Einkorn
    • Emmer
    • Farro
    • Kamut
    • Spelt (Dinkel)
    • Wheat bran
    • Wheat germ
    • Wheat starch
    • Hydrolyzed wheat protein
    • Beer, ale, lager
    • Fu
    • Freekah
    • Farina


  • Barley
    • Malt
    • Malt extract
    • Malt vinegar
    • Malt syrup
    • Malted barley & malted barley flour
    • Malted milk
    • Miso


  • Other
    • Rye
    • Bulgar
    • Triticale
    • Oats, oatmeal, oat flour & oat bran – unless specifically labeled gluten free
    • Breading & bread stuffing – includes breaded meat, fish, poultry
    • Groats
    • Brewer’s yeast
    • Dextrin
    • Graham flour
    • Atta (chapatti flour)
    • Seitan
    • Matzoh
    • Couscous
    • Durum
    • Semolina (pastas)
    • Soy sauce, teriyaki sauce & Worcestershire sauce – unless specifically labeled gluten free
    • Broths, soups & stocks – unless specifically labelled gluten free
    • Licorice
    • Ovaltine® (chocolate malt & malt flavours)
    • Smarties®



References (information & pictures):









General Inquiry Form

Outreach Inquiry Form