Celiac disease and Diabetes
The link between type I diabetes mellitus and celiac disease was first established in the 1960s. The estimated prevalence of celiac disease in patients with type I diabetes is approximately 8%. Most patients with both conditions have asymptomatic celiac disease or symptoms that can be confused with their diabetes. For this reason, many doctors recommend getting tested for celiac disease, after a diagnosis of type I diabetes. Similarly, for celiac patients, a type I diabetes test is necessary.
There is no established link between type 2 diabetes and celiac disease. Type 2 diabetes does have genetic components, but they are not associated with celiac disease genes.
The gluten-free diet may improve glycemic control for diabetic patients. Although that is still controversial, as some studies support the idea. Meanwhile, others suggest there is no difference in glycemic control between normal diabetic patients and diabetic with celiac disease.
Tips for the person with Type I Diabetes
Untreated celiac disease leads to damage to the small intestine, and may increase the risk of hypoglycemia. Therefore, the small intestine can no longer absorb nutrients properly, such as sugars, which makes diagnosis even more imperative.
Many people diagnosed with type I diabetes discover that they are celiac, through routine diabetes check-ups. Most diabetics report that they have no symptoms of celiac disease. But, both diseases usually go together. Therefore, if a diagnosis of celiac disease is confirmed, it is essential to follow a strict gluten-free diet. Above all, the sooner a gluten-free diet begins, the lower the chances of a person developing additional autoimmune disorders.
It can be very difficult to evaluate the effectiveness of a gluten-free diet, in a diabetic person, without symptoms of celiac disease. As well as that, difficult for that person, to be able to find motivation, in order to follow it strictly. Therefore, attention and follow-up with your doctor, is essential in these cases, to control the levels of antibodies in the blood, for celiac disease. In addition, weight gain or loss, fatigue, neuropathy and gastrointestinal problems may be related to celiac disease or diabetes. As a result, it can be difficult to differentiate the causes, without consulting your doctor.
General Guidelines and Advice
- Work with a dietitian with knowledge and credentials in diabetes. You can get the most personalized advice and successful changes in life, working individually with someone you trust.
- Many gluten-free flour substitutes are much higher in carbohydrate content than their gluten-containing equivalents. Gluten-free products can be highly refined, in addition to containing added sugars or starches, in order to mimic the same sensation and texture in the mouth. You may need insulin in smaller portions to enjoy these products.
- Always have gluten-free carbohydrates on hand, to control blood glucose, for cases where gluten-free foods can be hard to find.
- For the average person with celiac disease, a salad can be a reasonable option in a restaurant, which does not have a gluten-free menu. However, for someone with diabetes and celiac disease, a salad composed only of vegetables, meat and dressing, is probably too low in carbohydrates. Always come prepared with additions, or use a drink (such as a milkshake or a coffee with milk) as a source of carbohydrates if necessary.
- Tell a manager or authority about your medical needs, if you need to eat at an establishment that prohibits external foods and cannot meet your gluten-free needs.
Keep a doctor’s note on hand for places like the airport, cinemas, sports games, conference centers and amusement parks.
- Follow the general dietary advice for health, on a gluten-free diet. Whole grains and complex unprocessed and unrefined carbohydrates will give you maximum health benefits, while helping you maintain your blood sugar level.