Bone health in individuals with concomitant Type 1 diabetes and coeliac disease

Lead researcher

Dr Eleanor Thong

Main finding

Coeliac disease is 4 to 6 times more common in individuals with Type 1 diabetes, compared to the general population. Our study suggests that young adults with the dual autoimmune conditions of coeliac disease and Type 1 diabetes have a three-fold higher risk of fracture and hypoglycaemia (low blood sugars), compared to those with only Type 1 diabetes alone.


Centre for Endocrinology and Metabolism

Research group

Bone, Joint and Cancer


Dr Phillip Wong, A/Prof Anouk Dev, Prof Peter R Ebeling, Prof Helena Teede and A/Prof Frances Milat

Journal and article title

Most surprising

In our study population, patients who were vitamin D deficient (< 50 nmol/L) were at greater risk of hypoglycaemia, compared to those who were vitamin D replete. One other small study, albeit in a paediatric cohort, reported similar findings. Although the mechanism of vitamin D on hypoglycaemia is still unclear, it is thought to be a surrogate marker of general health and nutrition.

Future implications

Coeliac disease can interfere with carbohydrate absorption in the gut, leading to erratic blood sugar levels in patients with Type 1 diabetes. Clinicians should actively screen for hypoglycaemia in at-risk patients. Despite the increased risk of fracture in patients with concomitant Type 1 diabetes and coeliac disease, few had bone mineral density assessments performed. Both coeliac disease and Type 1 diabetes are known independent risk factors for fracture and bone health assessment in this cohort is recommended.

Disease/health impact

Type 1 diabetes mellitus, coeliac disease, bone health