If you have celiac disease that’s left untreated, you might develop hypoglycemia (low blood sugar). This happens when your damaged small intestine has a hard time absorbing nutrients.

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Celiac disease is an autoimmune condition that causes your body to attack your digestive system when you eat gluten. In most cases, you can manage it by avoiding gluten-containing foods like wheat, barley, and rye.

About 10% of people with celiac disease also have type 1 diabetes, another autoimmune disease. This can make it hard for your body to use carbohydrates.

A common side effect of this is hypoglycemia, which is when your blood sugar drops below a healthy level. It can make you feel dizzy, shaky, and lightheaded.

In this article, we unpack the connection between celiac, diabetes, and hypoglycemia.

In most cases, people with celiac disease who develop hypoglycemia also have diabetes. Having diabetes impairs your body’s ability to break down blood glucose, which in turn can lead to complications like hypoglycemia.

If you have celiac disease, you’re more likely to develop type 1 diabetes, another autoimmune condition. It means that your body doesn’t produce enough insulin, the hormone that breaks down blood glucose. This can lead to episodes of high blood sugar and also significant dips to low blood sugar (hypoglycemia).

People who have both celiac disease and type 1 diabetes can also have malabsorption, which means the body doesn’t take everything it needs from food during digestion.

After you eat, food travels through your body, where your intestines extract the nutrients you need. If your small intestine is damaged, it can’t properly extract these nutrients, leading to deficiencies.

You can have deficiencies in important micronutrients, like iron, that can cause problems with your skin, hair, and overall health. And if your body can’t absorb carbohydrates — its primary energy source — you can have low blood sugar. This can make you feel tired and weak.

Another factor to consider? Your microbiome.

Research has found that people with celiac disease can have changes to their gut bacteria. In addition to breaking down food and drawing out nutrients, these bacteria play an important role in keeping your digestive system healthy.

Changes in your gut microbiota can influence glucose metabolism, which is how your body breaks down and uses carbohydrates. While the research on glucose metabolism in people with celiac disease is relatively limited, it’s thought that these changes can make it harder to use glucose, contributing to hypoglycemia.

If you have celiac disease, it’s a good idea to keep an eye out for signs of hypoglycemia. Try to keep track of your symptoms so you can let your doctor know about any changes.

Early signs can include:

  • shakiness
  • sweating
  • dizziness
  • hunger
  • rapid heart rate
  • nausea

In more severe cases, you might experience:

  • confusion
  • blurry vision
  • coordination problems
  • loss of consciousness
  • seizures

If you or someone you’re with has signs of severe hypoglycemia, seek immediate medical attention, as this can be an emergency.

Experiencing hypoglycemia from time to time may be nothing to worry about. However, if you’re having it regularly, it’s a good idea to speak with your doctor. They can run tests to determine why it’s happening and help you manage it.

Namely, they’ll be looking for possible signs of type 1 diabetes. If your doctor suspects you have it, they’ll ask about your family history and order some tests. These can include:

  • Random plasma glucose: This measures your blood sugar at a single point in time.
  • A1C blood test: This can determine your blood sugar over the past 3 months.
  • Autoantibodies: In order to tell the difference between type 1 and type 2 diabetes, this test shows whether or not you have autoimmune antibodies in your blood.

Learn more about how type 1 diabetes is diagnosed.

Keeping your blood sugar in check is an important element of preventing future episodes of hypoglycemia. In addition to short-term measures like glucose tablets and sugary snacks, you can try making lifestyle changes that will be effective long-term.

Short-term strategies

For quick-acting relief, you can try eating glucose tablets or a sugary snack to get your blood sugar back up. Aim to consume about 15 to 20 grams of simple carbohydrates. This can look like a small glass of soda or juice, a handful of candy, or a banana.

Dietary changes

Making adjustments to your diet can help to stabilize your blood sugar, preventing dips and spikes. Try to eat small, balanced meals that have a good balance of carbs, proteins, and fats. It’s also essential to make sure you’re sticking to a gluten-free diet.

If you’ve been diagnosed with celiac disease and type 1 diabetes, it may be a good idea to speak with a registered dietitian. They can help you develop a sustainable eating plan and aid in sorting out any difficulties you’re having.

Lifestyle changes

Living with celiac disease can be difficult, especially if you have complications like hypoglycemia.

You can make living with the condition more manageable by planning and preparing your meals in advance. If you’re having a tough time with this, it may be a good idea to consult a registered dietitian for advice.

Additionally, be sure to have regular follow-up appointments with your primary care doctor. They can make adjustments to your treatment plan as needed, and they can also run tests to check for nutrient deficiencies that may be contributing to your hypoglycemia.

Left untreated, celiac disease can damage your small intestine, which can make it hard for your body to absorb nutrients. In most cases, people who experience hypoglycemia with celiac also have type 1 diabetes, another autoimmune condition.

If you’re experiencing hypoglycemia alongside your celiac disease, it’s a good idea to speak with your doctor. They can run tests and determine what’s going on and how to manage it.