DIABETES AND CELIAC DISEASE

What Is Celiac Disease?

Living with both diabetes and celiac disease can be a challenge, but it is not an impossible task.

Celiac disease is associated with the gluten protein in wheat, oats, barley and rye. The gluten damages the nutrient-absorbing lining of the small intestine (called villi). This damage causes diarrhea, weight loss and vitamin deficiencies—particularly deficiencies in B vitamins and especially folic acid. Poor digestive absorption leads to abdominal distention or bloating, muscle wasting and fatigue.

Once a gluten-free diet is started, the small intestinal villi, where nutrients are absorbed, begin to return to normal, a process that can take anywhere from one to six months.

In children, the trigger for celiac symptoms might be overeating wheat-containing foods at a party, sleepover or birthday splurge. Add a dose of emotional stress or a viral/bacterial infection, and gastrointestinal complaints can continue past the usual one to two days.

We do not yet fully understand why some people do not tolerate wheat and other gluten-containing foods. Further research is needed to solve this question of causation.

Nutrition Therapy for Celiac Disease

Steroid medication can suppress the intestinal symptoms that result from gluten consumption. However, most people with celiac disease will need to avoid all sources of wheat, rye, oats and barley until researchers gain further knowledge about how to customize nutrition therapy.

Corn and rice are the usual starch substitutes in the meal plan. Pasta products made from these sources are available. Millet and buckwheat do not contain gluten, although some doctors argue that they are often processed on the same grinding devices as wheat and therefore should be omitted from the diet because of cross-contamination.

A healthy diet for individual blood-glucose management can easily be made into a gluten-free diet with adequate freezer space and a list of reliable gluten-free food suppliers.

Many health food stores have numerous gluten-free items in the freezer case and snack food aisle. Twenty-five years ago, we had only rice cakes. Now rice cakes are a dieter’s snack food, and people with celiac disease can get frozen waffles, cookies and crackers.

Basics of Living Gluten-Free

That brings us to how much gluten is too much.

Diets containing as little as 2 to 5 grams of gluten per day (one slice of white bread contains 1 gram of gluten) have been reported to cause gastrointestinal changes. In one case, an 8-year-old boy whose only reported exposure to gluten was a Holy Communion wafer once a week had poor growth and partial villi atrophy.

Individual tolerances vary, but the rule of thumb is total avoidance if possible.

Learning the foods to avoid on a celiac diet is a lot like learning how to drive a car. Many foods can be hazardous to your health—just as road hazards can impair your driving. You need to stay alert, but you soon get used to it.

Here are some basic tips:

•           When ordering food in a restaurant, request that bread items be left off the plate.

•           The simplest way to avoid gluten is to follow a straightforward meal plan that also works well for diabetes management: for example, a serving of protein (broiled or baked), a starch such as a baked potato, steamed vegetables and fruit for dessert.

•           Snack on gluten-free foods later if you are still hungry. Birthday cake can be a big challenge—especially for the parents of a young person with celiac disease and diabetes. Today, gluten-free baking mixes make it possible to create a special cake for the occasion.

Your dietician is trained to  help you make the right choices and to work out a gluten-free diet for you.     

This information is bought to you as a free service from DNA Biopharm South Africa. The information herein is not intended to treat or diagnose any condition. Should you wish to try any herbal or natural remedy discussed in these pages, please consult with your healthcare practitioner. Should you require any information or advice on any topic related to diabetes, please follow the link to our website www.dna-biopharm.com and contact us.