Should People With Diabetes Eat a Gluten-Free Diet?

Going gluten-free may be helpful for some people with diabetes, but it’s not likely to make a difference for the majority of people with the condition.

Experts worry that the diet’s restrictions could create unnecessary lifestyle and management challenges for those without a medical need to avoid gluten. “It’s neither necessary nor helpful for someone with diabetes to avoid gluten in the absence of celiac disease or a known gluten intolerance,” says Rebecca Blake, RD, founder of Rebecca Blake Nutrition in New York City.

It is possible for anyone to have both diabetes and difficulty digesting gluten, and in some cases, the two conditions may be genetically linked.

The primary benefit of a gluten-free diet is the management of celiac disease and gluten intolerance.

If you have diabetes and have been diagnosed with celiac disease or your healthcare provider suspects gluten intolerance and has recommended following a gluten-free diet, you may experience the following benefits from doing so:

• Celiac Disease Management Damage to the small intestine caused by celiac disease can impair your body’s ability to absorb nutrients, posing a risk for your overall health. Impaired nutrient absorption can also affect blood sugar management, predisposing you to hypoglycemia, especially if you have type 1 diabetes. Treatment for celiac disease is a strict gluten-free diet to prevent further damage.

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• Gluten Intolerance Symptom Reduction If you have gluten intolerance, a gluten-free diet may help relieve the discomfort you experience when eating gluten.

There are additional potential benefits to going gluten-free, provided that your new diet emphasizes healthy and diabetes-friendly ingredients:

• A Whole Foods–Based Diet Foods that are naturally gluten-free include fruits, vegetables, nuts, seeds, lean sources of protein, and certain grains like brown rice and oats. These whole foods are beneficial for overall health, especially for someone with diabetes, says Sheri Gaw, RDN, CDCES, a diabetes specialist in San Jose, California. It’s not the elimination of gluten, but the balance and inclusion of whole foods that make this dietary pattern beneficial for people with diabetes, she says.
• Blood Sugar Regulation Support Some gluten-free swaps for foods that traditionally contain gluten can provide a nutrient boost, as well as encourage stable blood sugar levels. For example, “gluten-free, bean-based pastas made from lentils, edamame, or black beans are typically higher in protein and fiber than wheat-based pasta, which can lower their impact on blood sugar levels,” says Gaw.
• Elimination of Easy-to-Overeat Foods Gluten-containing foods like breads, crackers, cereals, snack mixes, and fast food are also ultra-processed foods that can feel addictive and are therefore easy to overconsume, says Kimberly Gomer, a registered dietitian in Summerland Key, Florida, who specializes in working with people with prediabetes and diabetes. “With insulin resistance in diabetes, one’s blood sugar goes skyrocketing after eating these foods, and then it crashes,” she says, which can cause problems with fatigue, energy, mood, and weight gain.

A gluten-free diet isn’t necessarily superior for people with diabetes. There are several risks and downsides to going gluten-free when you have diabetes but not celiac disease or gluten intolerance, which can actually make blood sugar management more difficult.

• A Limiting Dietary Lifestyle Many foods contain gluten, making this eating plan difficult to follow for some, says Gaw. One can expect a steep learning curve, lots of nutrition label reading, and a significantly restricted range of options.
• Potential Nutrition Gaps Gluten-free diets exclude a lot of ultra-processed, high-carbohydrate foods, but they also leave out nutritious whole grains like barley, farro, bulgur, and whole-wheat bread and pasta. “This can impact fiber, protein, vitamin, and mineral intake,” says Gaw, noting the potential for nutrient deficiencies if a gluten-free diet isn’t planned carefully.
• Overreliance on Gluten-Free Swaps A gluten-free packaged food isn’t automatically nutritious or blood sugar friendly. “Many gluten-free alternative products are more highly processed than the original gluten-containing products, which means they may lack some of the benefits of the original product and may even be higher in fat, carbohydrates, sodium, and other additives,” says Blake. Such foods can pose additional blood sugar management issues.

Your dietary lifestyle is a highly personal choice. With that said, experts may recommend a gluten-free diet if:

• You’re Diagnosed With Celiac Disease It’s unclear whether a gluten-free diet also helps manage diabetes, but it’s the required treatment for celiac disease.

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• You Feel Better on a Gluten-Free Diet If you experience gut discomfort, headaches, or joint discomfort after eating gluten-containing foods, you may try a gluten-free diet to see if your symptoms improve, says Gaw. However, Blake advises against going gluten-free on a whim. “We shouldn’t assume gluten is the culprit without [first] doing a well-controlled elimination [diet] and evaluating what’s different without gluten.”

After consulting with a healthcare provider, if you decide to try a gluten-free diet, consider the following expert suggestions to help make your new dietary lifestyle more successful:

• Focus on naturally gluten-free whole foods. Prioritize fruits, vegetables, lean protein, legumes, nuts, seeds, and gluten-free whole grains like quinoa and brown rice.
• Go slowly. If you don’t have celiac disease or gluten intolerance but you’d like to eat gluten-free, start by slowly phasing gluten-containing foods out of your diet, says Gomer. For example, swap flour tortillas for corn tortillas, or opt for sweet potato with dinner instead of bread. Rather than having crackers as a snack, reach for a handful of nuts.
• Avoid gluten-free junk food copycats. Gomer says removing ultra-processed foods from your diet, regardless of their gluten contents, will benefit your blood sugar and overall health.
• Read food labels. Gluten-free doesn’t necessarily mean blood sugar friendly. Check serving sizes and total carbohydrate contents as you make food choices, recommends Gaw.
• Work with a registered dietitian. These experts can help you approach a gluten-free diet in a balanced way, helping ensure that you’re getting the nutrients you need, managing your blood sugar effectively, and understanding whether going gluten-free is making a positive impact for you.

• People who have type 1 diabetes are more likely to have celiac disease due to genetic links between the two autoimmune disorders. A gluten-free diet is essential for those with both conditions.
• Unless you also have celiac disease or non-celiac gluten sensitivity, experts say a gluten-free diet is neither necessary nor particularly helpful for managing your diabetes.
• If you have diabetes and want to try going gluten-free, work with a registered dietitian to approach the diet in a balanced way, ensure you’re getting the nutrients you need and that your blood sugar management stays on target.
• When eating a gluten-free diet, focus on whole foods like fruits, vegetables, legumes, nuts, seeds, gluten-free grains, and lean meats, and avoid ultra-processed gluten-free junk foods, which can have a negative effect on blood sugar management and overall health.