Diabetes and Celiac

Did you know that it is estimated that between 1 in 10 and 1 in 20 type one diabetics also have Celiac disease? Why did it I have to get so sick and weak that I could barely function to get screened for Celiac? It would seem to me that Celiac screening should be a part of regular diabetes management.

Having diabetes and celiac presents some unique challenges for carb counting and absorption. As a person with diabetes, I learned how to judge the number of carbs in everything I ate through a combination of reading package labels, learning portion sizes and trial and error with insulin dosing. Once Celiac Disease was added into the mix, I had to learn entirely new carb counting skills. Many gluten free breads, crackers, cookies are higher in carbs and fat than their gluten filled counterparts. Because fat affects absorption speed and insulin sensitivity a whole new dose is necessary for those two gluten free cookies you enjoyed after dinner.

The average slice of white gluten bread has 80 calories, 0 grams of fat and 16 grams of carbohydrates. Gluten free bread can range from 110 to 170 calories for one slice. Yikes! I was diagnosed with diabetes at 11 years old, yet two years ago I had to relearn something that had become second nature.

To add to the confusion, one of the side effects of Celiac disease can be severe damage to the intestinal villi. Those are the little finger-like things that line your intestines and absorb food, nutrients etc. Well, as your body begins to heal on the gluten free diet your villi slowly start to absorb again. But it happens erratically and at different rates. That means that, assuming all other factors are equal, you can eat the exact same thing two days in a row, give the same insulin and still get wildly different blood sugar results.

That can lead to quite a bit of frustration with two diseases that require constant management and vigilance. What’s the point of trying when you just can’t get it right? Luckily I have an amazing endocrinologist. She helped me to understand that there was only so much I could do while I was healing and I couldn’t beat myself up over something over which I had no control.

Two years later, my antibodies are finally down to “undetectable” and my current 14 day blood sugar average is at 110! It’s still a constant learning process but I finally feel like it’s manageable.


Lynn Barry said...

Congrats! Can't be easy but you make it look easy. GOOD FOR YOU!

AmyT said...

Ah, diabetes and celiac -- the killer combo! I too live with them. Nice to see somebody else talking about the connection on the web. I had to find out the hard way :(

Anonymous said...

So glad to hear you be so strong with the combination of celiac and diabetes. I find that it is a whole new learning curve for my patients as well. One thing I encourage it using more whole grain flours like Amaranth, Quinoa and Teff so the carbs are more complex and digestion slows.
Thanks for keeping the connection complete.
GF Momma

Catherine said...

It's comforting and sad at the same time to know that there are so many of us out there.

At least the Web makes it easier for us all to share advice and information!