Living With Type 1 Diabetes And Celiac Disease

Living with type 1 diabetes can be tricky. Adding to this already complicated mix is when you find out you also have coeliac disease. What is coeliac disease? Are there any similarities between these two conditions? Or are they worlds apart? Can both be managed? Let’s find out.

Coeliac disease and type 1 diabetes have some key things in common. 

• Both are autoimmune conditions
• Both require a support network 
• Both require the person living with these conditions to be confident in self-management  

For people living with coeliac disease, they are unable to consume wheat, barley or rye-based foods as they contain the protein, gluten. Many people diagnosed with type 1 diabetes discover that they have coeliac disease through routine screening due to the known relationship between the two conditions. Other people experience symptoms such as unexplained weight gain or loss, fatigue, nerve pain and gastrointestinal problems. 

Once coeliac disease is diagnosed, the person will be advised to follow a strict gluten-free diet, as this is the only way to manage the disease. Symptoms will usually disappear if a gluten-free diet is followed. It is also feasible to achieve a good quality of life having both coeliac disease and type 1 diabetes. 

Increased awareness 

Regardless to whether you have an intolerance to wheat or not, people wanting to live a gluten-free life has been trending across the world, making following a gluten-free diet much simpler.

Increasingly, public places such as food establishments, airlines, or railways, have special letters, nutritional information and menus so people living with coeliac disease can enjoy days out. 

Coeliac disease or gluten sensitivity 

There has also been an increasing trend where people are choosing to avoid gluten, but that does not mean that everyone has coeliac disease. People that have a non-coeliac gluten sensitivity do not have an autoimmune disorder, but they may notice digestive problems, lethargy, headaches, joint pain, and other problems after eating gluten. The only way to keep symptoms at bay is to follow a gluten-free diet.

Many people living with coeliac disease or a gluten allergy choose to cook bread, pizza doughs or pasta at home with ingredients that is more suitable for them. This can offer to expand the variety and freshness of the diet, in addition to encouraging children to create their own recipes and their own food.

Work with your healthcare team 

It is recommended to work with a registered dietitian and diabetes educator to achieve solid knowledge of the changes necessary to face both conditions. In this way, you can ensure that your diet remains healthy and balanced with all the required nutrients.

Gluten-free products can be highly refined and contain added sugars or fats to mimic the feel and texture of the mouth. Other gluten-free alternatives, however, are made with very low-carb substitutes, and therefore standard carbohydrate counts are not appropriate. It is important to read nutritional labels very carefully and appreciate that the carbohydrate content of gluten-free foods may be different from a similar serving size of their gluten-containing alternative.

People living with type 1 diabetes know how important it is to resolve hypoglycaemia quickly. For a person with type 1 diabetes and coeliac disease, they must choose appropriate fast-acting gluten-free carbohydrates. They should discuss options with their diabetes healthcare team.

3 tips when you go out to eat 

1.    If a person living with type 1 diabetes and coeliac disease decide to eat outdoors it is always recommended that they check the establishment can provide gluten-free meals, meet any other dietary needs and check that there is no risk of gluten cross-contamination.

2.    To avoid this cross-contamination, both at home or when eating out elsewhere may be useful to ask these questions:

•  Do they have separate kitchen utensils, separate grill, separate fryer?
• Will the grill be cleaned before preparing your meat?

3.    There are a good number of applications and web pages where the Patient Community recommends establishments that offer safety in their preparations for people living with coeliac disease.

For people living with coeliac disease and type 1 diabetes, everyday decisions can become tricky. By working with your healthcare team, having open communication with your support network and learning more about these conditions will help to improve your self-management. Plan ahead and take each day as it comes – its all going to be okay. 

Reference
^{1.    Kylökäs A, Kaukinen K, Huhtala H, Collin P, Mäki M, Kurppa K. Type 1 and type 2 diabetes in celiac disease: prevalence and effect on clinical and histological presentation. BMC Gastroenterol. 2016;16(1):76. 
2.    Leonard MM, Cureton PA, Fasano A. Managing coeliac disease in patients with diabetes. Diabetes Obes Metab. 2015;17(1):3-8.}