Celiac disease can affect anyone irrespective of age, ethnic background and sex. According to the Canadian Celiac Association, almost one per cent of Canadians have celiac disease. You may also be at higher risk if someone in your family, such as a parent, brother, sister or child, has celiac disease. Type 1 diabetes also increases the risk. It is thought that between four and nine per cent of children with type 1 diabetes also have celiac disease.
Type 1 diabetes and celiac disease appear to have a common genetic link found on several chromosomes (structures that carry genes) in the body. In those at risk, the immune system damages cells after being exposed to something in the environment. Researchers are working to identify the role the environment plays, but we do not yet know the trigger. A similar process happens in both type 1 diabetes and celiac disease. With type 1 diabetes, the immune system damages the islet cells in the pancreas that produce insulin. In celiac disease, the immune system harms cells of the small intestine. It is possible that for some people, gluten alone or with another factor, may damage the immunity of the body and increase the risk of type 1 diabetes.
In celiac disease, the immune system makes antibodies when the body is exposed to gluten. If you have symptoms, or family members with the condition, your doctor will order blood tests to check for these antibodies. If blood tests show them, you should have a small sample of tissue from the intestine removed to check for damage. This will require referral to a doctor who performs this type of procedure.
Staying healthy with celiac disease and diabetes means avoiding all foods that contain gluten. Most breads, pasta and cereals contain gluten. Following a gluten-free diet relieves symptoms, heals the intestine and prevents further damage. (See Safe Choices sidebar below). Some people with diabetes and celiac disease may notice improved blood glucose control and less hypoglycemia on a gluten-free diet.
Vegetables prepared with no added sauces are a good choice. Avoid breaded coatings and batters.
Fruits prepared with no added sauces or toppings are a good choice. The Canadian Celiac Association cautions that since dates may be dusted with dextrose or wheat flour, it is best to check the ingredient list or ask the grocer before buying bulk dates.
This food group includes sugars and snack foods. Brown and white sugar, corn syrup, molasses, maple syrup, honey and jam are all gluten-free. Check food labels carefully to ensure there are no ingredients that contain gluten. Remember to talk with your dietitian about using snack foods.
Butter, margarine and vegetable oils do not contain gluten. Avoid salad dressings and cooking sprays that include wheat flour or wheat starch.
|Meat & Alternatives
Plain meat, fish, chicken, eggs, dried peas, beans, lentils, aged cheese, cottage cheeses and tofu are all safe choices on a gluten-free diet. Be aware that meat substitutes, cheese spreads and sauces, processed meats, imitation fish products (such as imitation crab), seasoned and dry roasted nuts and seeds may contain hydrolyzed wheat protein, wheat starch and other fillers containing gluten
|Grains & Starches
Breads, crackers, pasta and cereal made with rice, corn, soy and potato flours are generally safe choices. These foods are found in some grocery stores and specialty food shops, or can be made at home.
Foods in this group, such as coffee, tea, diet drinks, spices, seasonings and condiments, are low in carbohydrate and calories.
Check food labels carefully as some products, such as curry paste, seasoning mixtures,
flavoured teas and coffees and specialty mustards, may contain ingredients with gluten.
|Milk & Alternatives
Milk, evaporated milk, milk powder and cereal cream are gluten-free choices.
|For more information
The Canadian Celiac Association provides information on celiac disease, gluten-free foods and recipe books through newsletters and meetings. Check to see if there is a branch near you.
www.celiac.ca or 1-800-363-7296
For those with diabetes who are diagnosed with celiac disease but have no symptoms, it is uncertain how much following a gluten-free diet will help. Researchers are working to identify the best treatment for people without symptoms. It is possible that even though you have no symptoms, damage still occurs. For this reason, it may be worth avoiding gluten.
Carefully check ingredients on all food labels for grains and other ingredients that may contain gluten. Do this even with products you use often, as ingredients in a processed food may change. To be certain a product is still gluten-free, check food labels regularly and monitor the Canadian Celiac Association website www.celiac.ca for notices on food products and recalls.
Many other foods are safe for people with celiac disease. Contact your dietitian for more information about celiac disease and foods included in the celiac diet. By caring properly for both your diabetes and celiac disease, you can feel better and avoid the risk of complications.