Published on 21 May 2025
For those living with the daily challenges of diabetes it can be devastating to also receive a diagnosis of coeliac disease – with an overwhelming feeling of negotiating an ever-more complex dietary maze.
Research suggests that type 1 diabetes (T1D) and coeliac disease, both autoimmune conditions, share a similar genetic profile. Up to 10% of people with coeliac disease also have type 1 diabetes, compared to only about 1% of the general population, so there is a significant overlap.
Understanding the connection
Coeliac disease and type 1 diabetes (T1D) both impact the body's ability to process food and nutrients, yet they affect different systems. Coeliac disease is an autoimmune disorder where the ingestion of gluten damages the small intestine, while type 1 diabetes affects the endocrine system, causing the body's immune system to attack cells in the pancreas, stopping it from making insulin.
Unlike type 1 diabetes, there is no established link between type 2 diabetes (T2D) and coeliac disease.
Dual diagnosis challenges
The symptoms of coeliac disease and diabetes can sometimes overlap, making it challenging to diagnose both conditions at the same time.
If you’re concerned you may have either type 1 or type 2 diabetes or coeliac disease, book an appointment with your GP. An appointment with one of our private GPs at Benenden Hospital can get you the answers you need, quickly.
They can refer you for a diagnostic test for type 1 diabetes, type 2 diabetes and coeliac disease, which all require a blood test. A tissue biopsy from the small intestine via endoscopy may also be required to confirm a diagnosis of coeliac disease.
Our specialist diagnostics suite provides safe and rapid access to tests and scans when you need them.
Dietary management
If you receive a dual diagnosis of coeliac disease and diabetes, your GP will need to refer you to a dietitian or gastroenterologist for specific tailored advice on diet management.
There isn't a one-size-fits-all diet for everyone with type 1 or type 2 diabetes, but you can adopt healthy eating habits which can help you manage your blood glucose (sugar), blood pressure and cholesterol levels.
The most significant dietary concern for people with coeliac disease is avoiding gluten, a protein found in wheat (including freekeh, cous cous and bulgur wheat), spelt, barley, rye and commercial oats, that can cause inflammation and damage to the small intestine.
Abir Hamza-Goodacre, our Registered Nutritional Therapist at Benenden Hospital, says:
“For individuals with diabetes, managing intake of starchy carbohydrates and sugars to control blood sugar levels is equally important. Therefore, the challenge becomes finding a diet that accommodates both gluten-free and blood sugar control needs. Gluten free grains include quinoa, buckwheat, rice, gluten free oats, millet and amaranth. Be careful of some foods that are labelled gluten free but are high in sugars and low in fibres, for example, white rice products, sugary cereals and others. Choose whole grains where possible and replace some of the starchy carbohydrate on your plate with more vegetables.”
So, what dietary habits can you adopt that enable you to effectively manage both conditions?
1. Avoid processed and simple carbohydrates
People with diabetes, especially those with type 1 diabetes, must monitor their carbohydrate intake to maintain balanced blood sugar levels. It is essential to check labels carefully, as foods such as gluten-free pasta and bread may be high in carbohydrates and contribute to blood sugar spikes if consumed in large quantities.
What healthier carbohydrates can I eat?
Healthier carbohydrates – those that are unrefined, unprocessed complex carbohydrates - are suitable for those with diabetes and coeliac disease. They include:
- Sweet potatoes
- Pulses such as chickpeas, beans and lentils
- Nuts - plain unflavoured almonds, cashews, peanuts, walnuts and sunflower seeds are all suitable for those with coeliac disease. They’re high in protein, but they're low in carbohydrates, helping to fill you up while keeping blood sugar low
- Brown rice noodles
2. Avoid highly processed foods
Both people with coeliac disease and diabetes should avoid highly processed foods, which tend to be high in salt and sugar, low in fibre and digested quickly, which can be particularly detrimental for diabetics.
What foods should be avoided?
Some of the worst highly-processed culprits which both coeliacs and diabetics should avoid are:
- Breakfast cereals
- Cakes, pastries and biscuits
- Tinned soup
- Condiments and gravies - gravy granules are often thickened with wheat flour
- White rice
- Crisps
- Ready meals
- Margarine
- Processed meats
- Desserts
- Sweets
- Fizzy drinks
3. Avoid high glycaemic index foods
Both conditions benefit from avoiding high glycaemic index (GI) foods. The GI measures how quickly a carbohydrate-containing food raises blood sugar levels. High-GI foods, such as white bread, white rice and processed snacks can cause rapid spikes in blood sugar, which are difficult for people with diabetes to control.
What low GI index foods can I eat?
Some gluten-free foods may have a higher glycaemic index, so it’s important to focus on foods such as:
- Low starch vegetables - such as broccoli, cauliflower, asparagus, leeks, spinach, bell peppers, onion and aubergine
- Fruit - portion control is important for fruits with higher sugar content like grapes or bananas, which may cause blood sugar spikes
- Lean meats
- Fish
- Eggs
- Dairy – such as milk, cheese and yoghurt, providing they have not been processed or do not contain artificial flavours
- Naturally gluten-free whole grains with a low GI - such as buckwheat, brown or wild rice and quinoa. Oats are safe to eat for most people with coeliac disease, but it’s important that they aren’t produced in the same factory as wheat, barley and rye to avoid contamination
By focusing on whole foods, avoiding processed sugars, and carefully choosing gluten-free options with a low glycaemic index, individuals with coeliac disease and diabetes can better manage their conditions and lead healthier lives.
Further information
The Diabetes UK website has a great recipe finder, which can be set to display diabetes-friendly AND gluten-free recipes.
Coeliac UK has a Live Well Gluten Free app – find out more here.
Your GP can refer you to our hospital for a private diagnostic endoscopy by completing the referral form.
To find out more about our self-pay gastroenterology procedures, get in touch using our online enquiry form or contact our Private Patient Team via Livechat or on 01580 363158.