Diabetes and Celiac Disease | GlucoseZone

Diabetes and Celiac Disease

A common condition that people living with diabetes might also experience is Celiac disease. Autoimmune diseases tend to be comorbid, meaning they occur together, so those with type 1 diabetes in particular, since it’s also autoimmune, are more likely to have Celiac disease than those without. So what is it? Celiac is a digestive condition triggered by the consumption of the protein gluten. When people with Celiac eat foods containing gluten they experience an autoimmune reaction in their small intestine, causing damage to the inner surface of the small intestine and an inability to absorb certain nutrients. Not absorbing these nutrients affects children’s growth and development as well as negatively impacting the nutritional status in both children and adults. Here is a list of symptoms that eating gluten can cause:

  • stomach pain and upset
  • bloating
  • diarrhea
  • joint pain
  • muscle cramps
  • skin rash
  • mouth sores
  • tingling in legs or feet
  • flu-like symptoms or malaise

There is currently no treatment that can cure Celiac disease, with the only solution being to stop eating foods that contain gluten. Therefore it is crucial to know which foods contain gluten so you can remove it from your diet and prevent any damage to your small intestine. The biggest culprit that you will notice in most foods is wheat and wheat products and other grains. These foods include:

  • wheat berries
  • durum
  • emmer
  • semolina
  • spelt
  • farina
  • farro
  • graham
  • KAMUT® khorasan wheat
  • einkorn wheat
  • rye
  • barley
  • triticale
  • malt in various forms including: malted barley flour, malted milk or milkshakes, malt extract, malt syrup, malt flavoring, malt vinegar
  • brewer’s yeast
  • wheat starch
  • oats that do not say gluten free

Even if a food doesn’t contain gluten it may be contaminated by gluten, such as oats, because of the way the food gets processed in facilities in close proximity to wheat. It is important to read food labels carefully. The term “gluten free” is a label that is defined by law in the US based on the parts per million of gluten that exists in the food, so always be on the lookout for the gluten free label as an indicator that a food is safe to eat. You can also check websites like Glutenfree Watchdog, which is a good reference when you are out shopping.

If you need to avoid gluten, there are some other products besides food that you need to avoid as well. Pay particular attention to these products and make sure you read the labels when available to see if there are any ingredients listed that contain gluten:

  • the glue on envelopes
  • cosmetics, beauty products, and toiletries
  • vitamins and supplements
  • medications

Also be aware that certain cooking methods in restaurants can cause contamination of your food with gluten, such as the fryer basket, pots, pans, oven, or grill, where gluten-containing foods leave residue that can contaminate your food. If you are going out to eat at a restaurant that is not strictly gluten free, make sure you inform your waiter from the beginning that you need to have your food prepped in an area that is free from any gluten.

So far we’ve given you a lot of rules about what not to eat, so you might be asking yourself just what the heck you can eat. We’re glad you asked! The good news is that a diet that consists of whole non-processed foods like fruits, vegetables, plant or animal protein, and sources of non-wheat carbohydrates (like brown rice or quinoa) are all perfectly fine to eat when you’re on a gluten free diet. This diet is not only appropriate for those avoiding gluten, but is the healthiest diet for everyone, including people with or without diabetes. If you don’t have Celiac disease there is no need to avoid eating wheat or other gluten-containing foods, but these foods shouldn’t make up the bulk of your diet. Especially for those of us living with diabetes, we need to be mindful of our carbohydrate consumption because our bodies simply can’t handle very large amounts. That being said, you can enjoy your slice of bread or bowl of pasta if those foods work for your body and make you feel good—just make sure you include mostly whole, nutritionally dense foods like veggies, fruits, and proteins along with it.

Lastly, we want to briefly discuss the importance of diagnosing Celiac disease, as there are many long-term health conditions that can result from undiagnosed instances of Celiac. Many people experiencing symptoms don’t realize that they have Celiac and might be dealing with these issues as a result:

  • iron deficiency anemia
  • early onset osteoporosis or osteopenia
  • infertility and miscarriage
  • lactose intolerance
  • vitamin and mineral deficiencies
  • ventral and peripheral nervous system disorders
  • pancreatic insufficiency
  • intestinal lymphomas and other GI cancers (malignancies)
  • gall bladder malfunction
  • neurological manifestations, including ataxia, epileptic seizures, dementia, migraine, neuropathy, myopathy, and multifocal leucoencephalopathy

If you are experiencing any of these conditions or any of the symptoms we discussed above, see your doctor immediately and ask if you can get screened with a blood test. It is important that if you do suspect you have Celiac, that you do NOT stop eating gluten. Your doctor will want to confirm your blood test with an endoscopy to check for any damage in your small intestine. The intestinal wall needs to be exposed to gluten to show visible damage—the exposure causes the fingerlike projections in the intestine, called villi, to become flattened out, which will confirm a positive diagnosis of Celiac disease. Once it has been confirmed by your doctor, he or she will then instruct you to remove gluten from your diet so the villi can heal. Remember that not everyone with diabetes will develop Celiac disease—you must be genetically predisposed to it. If you do have Celiac, though, once you begin eating a gluten free diet, you will notice how much better you feel and how much better your diabetes will be managed as well.

By: Lauren Szalkiewicz and LaurieAnn Scher, MS, RD, CDE