Diabetes and the Celiac Link

If you have Type 1 diabetes you probably would never imagine you could have Celiac's Disease too. It has been estimated that one in twenty diabetics also has Celiac Disease.

Catherine Oddenino has had Type 1 diabetes since she was eleven. She is thirty-one now and is adept at counting carbohydrates and dosing insulin. However, when she was in her 20's she hit something new with her health. Whenever she ate, she felt like she had food poisoning. She visited her doctor and was told to cut dairy from her diet. She was then sent to a gastroenterologist. The gastroenterologist was tipped off by her diabetes and so then tested her for Celiac Disease. Two weeks later the results of the test came back and the culprit of Catherine's "poisoning" was gluten and not dairy. Now, with being careful of how many carbohydrates she eats, Catherine also has to make sure she doesn't eat even a speck of gluten.

Both diabetes and Celiac disease are autoimmune disorders. Thyroid disease, Multiple Sclerosis, Rheumatoid Arthritis, among other conditions also belong in this group. In autoimmune disorders, the immune system is overactive an causes the body to attack its own cells.

The science on how Type 1 diabetics and Celiac Disease are related is still emerging. Dr. Alessie Fasano, the medical director of the center of Celiac research at the University of Maryland has two thoughts: 1) the diseases share common genes and, 2) some patients have Celiac Disease which later turns into diabetes.

A study was conducted and published in the New England Journal of Medicine in 2008, that found that the genes involved in Celiac Disease are also in Type 1 diabetes.

It might seem impossible that Celiac Disease can cause diabetes, but typically a Celiac Disease diagnosis comes after a diabetes diagnosis. For every person diagnosed with Celiac Disease at least another fifty aren't even aware they have it. With those that are undiagnosed, experts think that the chronic "leaky gut" present in Celiac patients allows triggers like food proteins and viral and bacterial particles to enter the body by way of the intestine and into the space beneath. A large number of autoimmune cells reside in this area and this causes the person to "develop secondary autoimmune conditions if genetically predisposed," says Fasano. Even though this question has not been fully answered, a fat that remains is that most of people diagnosed with Celiac Disease are already on diets for diabetes.

Gluten free foods can vary significantly in the amount of carbohydrates they contain. For example, regular wheat noodle contain 23.8 grams of carbohydrates per 150ml of pasta. Rice spaghetti has 42 grams for the same serving size.

Foods can also have different fat and protein rations, which can delay the rate of carbohydrate absorption. "People may end up requiring more insulin, or less insulin," said Suzanne Simpson, a dietician at the Celiac Disease Center at Columbia University in New York.

Devon Carlson has had Type 1 diabetes since she was a child. At the age of twenty-six, routine blood tests found antibodies for Celiac Disease. An intestinal biopsy confirmed Celiac Disease. With this diagnosis she transitioned to a gluten-free diet and her blood sugar spun out of control. She had been trying several gluten-free foods but found they have a lot sugar and fat. The sugar and fat can delay the rate of the absorption of the carbohydrates. The increased fat in Carlson's body caused her body to absorb carbohydrates at a different rate, causing the dose of insulin to be off. She says, "Once I figure out which gluten-free processed foods I would keep in my diet and stop trying all these different foods, I got my blood sugar back under control. Carlson began choosing whole foods, fruits and vegetables and gluten-free grains. Because she did this it made her insulin dosing a simpler task.

Having both Celiac Disease and diabetes causes a new set of challenges if you are traveling or dining out, so it is important to monitor your blood sugar carefully.

Catherine Oddenino has both Celiac Disease and diabetes and held a job that where she had to travel weekly. She has this to say, "Traveling with both Celiac and diabetes requires thinking ahead in terms of where your next meal is going to be, and what you're going to have to eat."

It's hard to find gluten-free foods on the road, but if you also have diabetes, this means you can't leave anything to chance. Diabetics need to eat at regular intervals to keep blood sugar levels stable.

Symptoms are often vague for Celiac's Disease and because of this people who have Celiac's Disease often go undiagnosed for years. The symptoms of Celiac's are diarrhea, bloating, fatigue, among other symptoms. Most family doctors don't even know how common Celiac's Disease is. This issue warrants concern because undiagnosed Celiac's Disease increases the risk of osteoporosis, intestinal cancers, neurological disorders and infertility. Increasing numbers of diabetics are being screen for Celiac's Disease since there is a strong association between the two autoimmune diseases. This means that silent Celiac's, those who show no symptoms, are being put on a gluten-free diet.

Researches are continuing to discover the origins of the two diseases. Therefore, the relationship between them should become clearer. The hope we have here is diagnoses can be made to help more people live to their healthiest potential.

If my mother was still alive, she would be able to relate to this article. She too was diabetic and had problems with gluten. Whenever she ate gluten-filled products her eczema would flare up. She never did go and get tested for Celiac's Disease. She just knew that when she ate something with wheat she wouldn't do so well afterward. Unfortunately, she never did change her diet. Perhaps, she didn't have enough knowledge and guidance to do so. Not like there is today. She also had trouble controlling her blood sugar and several times had to have her medication adjusted. Still, she struggled with her diabetes right on up to her passing. I wish she was here now so I can show her this article and maybe it would have opened her eyes to gluten intolerance.

RESOURCES:

Allergic Living Magazine. "The Diabetic Link" Claire Gagne pgs37&38. 2010