Ask the experts
Is there a relationship between celiac disease and diabetes?
Doctor's response
Yes, there is. There is an association between celiac disease and diabetes. This association specifically involves type 1 diabetes which is insulin-dependent diabetes. This form of diabetes is the result of an autoimmune process. In this process, the body identifies a structure of its own -- in this case, the pancreas -- as foreign and attacks it by producing antibodies directed against it. The antibodies travel through the blood and damage the pancreas. The pancreas is so damaged that it cannot make enough insulin and the patient develops type 1 diabetes.
In general, diseases of autoimmunity tend to occur in clusters. Approximately 6% of all patients with type 1 diabetes have celiac disease, which is also an autoimmune disease.
Of special note, there are several types of a condition called the polyglandular autoimmune syndrome (PGA). PGA type II is the most common of these conditions and is associated with a number of different autoimmune diseases which occur in clusters. PGA type II is defined as the occurrence of 2 or more of the following findings in the same individual:
- Primary adrenal insufficiency, which is also called Addison's disease;
- Autoimmune thyroid disease, which is also called Graves disease;
- Myasthenia gravis;
- Primary hypogonadism;
- Type 1 diabetes mellitus; and take special note,
- Celiac disease.
PGA type II is thus a syndrome in which celiac disease and type 1 diabetes are associated.
Patients with PGA type II need to be closely followed medically and re-evaluated periodically as to the degree of autoimmunity and the possible development of other diseases within this cluster. In a family where this syndrome has been identified, other family members need to be counselled as to the risks of developing an autoimmune disease. Relatives should have a detailed medical history, physical examination and laboratory tests every 3-5 years with measurements of blood sugar, thyroid function, vitamin B12 levels, and other laboratory tests, including hormone studies, if appropriate.
Medical Author: Ruchi Mathur, MD
Medical Editors: Barbara K. Hecht, Ph.D. and Frederick Hecht, M.D