A genetic link exists between Type 1 Diabetes and coeliac disease. Unfortunately, Being diagnosed with either one of these conditions increases your risk of developing the other. However, improving one condition can encouragingly better the other and improve your overall health and wellbeing. Read below to learn how you can achieve this.
What is coeliac disease?
Coeliac disease (CD) is an intolerance to gluten which is a protein found in grains like wheat, barley, rye, semolina, spelt, cous cous, oats and triticale. When individuals with CD consume foods containing gluten like regular bread, their small bowel becomes inflamed and damaged. Symptoms of CD include abdominal bloating and cramping, fatigue, weight loss, unstable blood glucose levels (BGLs) and iron deficiency anaemia.
CD is diagnosed by a blood test that measures antibody levels. If the blood test indicates CD, a diagnosis is confirmed by taking a small bowel biopsy.
A lifelong gluten-free (GF) diet is the most effective treatment for CD.
The relationship between coeliac disease and diabetes
Type 1 diabetes and CD are both autoimmune diseases which means they are more likely to occur together. It is estimated that 5% of people with type 1 diabetes also have CD, whilst the prevalence of CD in the general population is just 1% (National Diabetes Services Scheme, 2020). Often people with type 1 diabetes do not experience any symptoms of CD or the symptoms are confused with those of diabetes. For this reason, it is really important that routine CD screening is done with your doctor to prevent long term damage to your small bowel.
It is also possible for individuals to have both type 2 diabetes and CD, but unlike type 1 diabetes the two conditions are unrelated.
Nutrition implications for those with diabetes and CD
Eating regularly and spreading carbohydrate foods evenly throughout the day assists with maintaining good energy levels and stabilising BGLs. However, a lot of carbohydrate foods like cereals, breads, pasta and crackers contain gluten. Therefore, people with CD must incorporate gluten-free (GF) carbohydrate alternatives into their eating pattern.
Below are some examples of gluten free foods. The foods in bold are also low glycaemic index. You may remember from a recent blog that low glycaemic index foods help keep your BGLs stable throughout the day.
- Quinoa, buckwheat, and doongara rice
- All legumes (check ingredients for gluten within tinned beans with sauces)
- All dairy products and alternatives (check ingredients for gluten with custard and yoghurt)
- GF bread, pizza bases and tortillas made from corn, rice, soy or potato
- Pulse pastas, vermicelli rice noodles and buckwheat soba noodles
- Rice bran, puffed rice and corn, rice porridge, GF rice flakes, GF muesli
- Corn thins, rice and corn cakes, GF crackers
Minimising the risks associated with coeliac disease and diabetes
Untreated CD increases your risk of developing other medical conditions. The damage CD inflicts on the wall of the small bowel can significantly decrease the absorption of essential nutrient like calcium and iron. The risk of hypoglycaemia (BGLs <4.0mmol/L) is also higher if glucose is not properly absorbed.
Simple tips to improve your diabetes and coeliac disease
- Maintain a strict life long GF diet. Even very small amounts of gluten can cause ongoing damage to the wall of the small bowel, hindering absorption of glucose and essential nutrients.
- Download the Coeliac Australia ‘Gluten Free Ingredient List’ app.
- Eat regular meals with GF carbohydrates (listed above) evenly throughout the day to help maintain optimal glucose levels.
- Choose foods rich in calcium (cheese, milk and sardines) and iron (red meat, seafood and beans) to reduce the risk of deficiencies.
- Read nutrition information panels to make an informed decision about the carbohydrate content of GF foods (Click ‘What is Carbohydrate Counting?’ for more information).
- Carry GF foods with you like nut bars or crackers when GF foods may be difficult to find.
How do I know if a packaged food contains gluten?
Fortunately, all food manufacturers are required by Food Standards Australia and New Zealand to declare all gluten containing ingredients on the food’s packaging. Some of these ingredients to look for include wheaten corn flour, wheat starch, malt, malt extract, malt dextrin and thickeners 1400 to 1450.
If you will like individualised information to improve coeliac disease and diabetes, book an appointment online
References:
National Diabetes Services Scheme. (2020). Coeliac disease and diabetes fact sheet. Retrieved from https://www.ndss.com.au/about-…
