People with type 1 diabetes have a higher risk of coeliac disease. Both conditions are autoimmune disorders. According to Coeliac UK between 2 and 10% of people with coeliac disease will also have type 1 diabetes. Some people with type 1 diabetes have silent coeliac disease, which means that no symptoms are apparent. It can also be easily missed because symptoms of feeling unwell may be attributed to the diabetes. Experts agree that all people who suffer from diabetes 1 should be screened for coeliac disease.
Type 1 diabetes is usually diagnosed in children and young adults. It is not the diabetes your grandpa developed when he turned 80. In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.
1. People with coeliac disease have an increased risk of diabetes 2.
Diabetes 2 is non insulin dependent diabetes. It is the most common type of diabetes and is the type of diabetes that is diagnosed in late adulthood. The bodies of people with diabetes 2 do still produce insulin. But either their pancreas does not make enough insulin or the body cannot use the insulin well enough. This is insulin resistance. There is no link between coeliac disease and type 2 diabetes. The risk of diabetes 2 in people with coeliac disease is the same as for the general population. The risk factors for diabetes 2 are being overweight, lack of exercise, high blood pressure, family history, age, and others. These risks are the same for coeliacs and non coeliacs.
2. Sugar in gluten free foods causes diabetes 2 in people with coeliac disease.
This might be partially true. A diet that is high in sugar can contribute to weight gain, which combined with other risk factors increases the likelihood of developing diabetes 2. But this is not limited to people with coeliac disease. It is the same for the general population. If a person with coeliac disease does not have diabetes 1, the international health recommendations apply. Eat a healthy balanced diet and increase your activity levels to avoid health problems. Just make sure your diet is gluten free.
3. People with coeliac disease and diabetes 1 should follow a sugar free diet.
When a person with diabetes 1 and coeliac disease is established on a gluten free diet, absorption of nutrients from food will increase as the intestine heals. This will affect blood sugar control. It is important to follow advice from a healthcare team regarding possible changes in insulin requirements. However, many people think that they can eat all gluten free food as long as it is sugar free. This is a myth. In reality sugar can be consumed by people with diabetes as part of a healthy diet in cooking and baking. High sugar foods are not healthy for anybody and will not help with glucose control, but sugars are not prohibited. Sadly, many gluten free products are high in sugars. Try to limit the consumption of high sugar foods, but that is not enough.
If a person has diabetes and coeliac disease these points are important to remember:
- Eat regularly and do not skip meals. Try to include a starchy carbohydrtae with every meal. Carbohydrates are important to control blood sugar levels. Follow the advice of a dietitian with regards to how much carbohydrates to include in your diet as this varies depending on age, activity level and weight.
- Include foods with a lower glycaemic index. The glycemic index, or GI, measures how a carbohydrate-containing food raises blood glucose levels. Foods with a low or medium GI raises blood glucose less than foods with a high GI. Fat and fiber tend to lower the GI of a food. As a general rule, the more cooked or processed a food, the higher the GI (although there are exceptions). This means that gluten free highly processed packed products tend to have a high GI index and will raise blood glucose levels fast. Low GI foods that are gluten free include basmati rice, naturally gluten free grains, gluten free pasta, gluten free multigrain, wholegrain or seeded bread, sweet potato, corn, yam, beans, peas, legumes, lentils, most fruit, and non starchy vegetables.
- Eat a healthy diet and maintain a healthy weight.
- Aim for 5 servings of fruit and vegetables per day
- Avoid diabetic foods and drinks. The ‘suitable for diabetics’ label is a gimmick. These foods contain the same amounts of fats and calories and have a laxative effect that can affect blood glucose levels.
Include plenty of naturally gluten free foods in your diet. Do yourself a favour and limit the packaged highly processed gluten free junk. And don’t forget to exercise!
Sources and further reading:
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