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Navigating Coeliac Disease and Diabetes: A Comprehensive Guide

Living with diabetes comes with its set of challenges, and for some individuals, coeliac disease adds another layer of complexity to their dietary management. Coeliac disease is a lifelong autoimmune condition triggered by gluten consumption, primarily found in wheat, rye, and barley. In this comprehensive guide, we'll explore the intersection of coeliac disease and diabetes, addressing symptoms, treatment, and practical advice for managing both conditions.



Coeliac Disease and Diabetes Connection

Coeliac disease and diabetes share a common thread—they are both autoimmune conditions. While coeliac disease is more frequently found in individuals with type 1 diabetes, it can also affect people without diabetes. Up to 10% of individuals with coeliac disease also have type 1 diabetes. It's important to note that type 2 diabetes, a different form of the condition, does not increase the risk of developing coeliac disease.


Recognizing Symptoms

The symptoms of coeliac disease can vary in severity, and some individuals may not even be aware that they have the condition. Common symptoms include:

  1. Diarrhoea: Frequent loose stools are a classic sign of coeliac disease.

  2. Bloating: Abdominal discomfort and bloating may occur after consuming gluten-containing foods.

  3. Nausea: Feeling queasy or nauseated is another symptom.

  4. Mouth Ulcers: Painful mouth ulcers can be indicative of coeliac disease.

  5. Tummy Aches: Persistent abdominal pain or discomfort.

  6. Unexpected Weight Loss: While not present in all cases, unexplained weight loss can occur.

  7. Hair Loss: Thinning or hair loss may be a symptom.

  8. Anaemia: Coeliac disease can lead to nutrient malabsorption, including iron, causing anaemia.

Treatment: A Gluten-Free Diet

Once diagnosed with coeliac disease, the only effective treatment is a lifelong commitment to a strict gluten-free diet. This means eliminating all sources of gluten from your diet, including wheat, rye, and barley. Cutting out gluten allows the lining of your gut to heal, improving nutrient absorption, including carbohydrates.


Coeliac Disease and Type 1 Diabetes

People with both coeliac disease and type 1 diabetes face additional considerations. Recurrent hypoglycemia (hypos) can be a sign of coeliac disease in individuals with type 1 diabetes because their bodies struggle to use carbohydrates efficiently. If you have both conditions, it's advisable to consult a dietitian for personalized guidance on managing your diet.


Gluten-Free Diet and Diabetes

Starting a gluten-free diet may impact your blood glucose levels, as the healing of your gut can lead to improved nutrient absorption, including carbohydrates. Be prepared for potential changes in your blood glucose levels and stay in close contact with your diabetes healthcare team. Medication requirements may need adjustment.


Choosing Gluten-Free Foods

Recent UK food labelling laws have made it easier to identify gluten-free foods. Manufacturers must clearly highlight gluten-containing ingredients, such as wheat, barley, and rye, in bold. Common foods to avoid with coeliac disease include those listed above.

While most people with coeliac disease tolerate oats, it's important to ensure that they are uncontaminated by gluten from wheat, barley, or rye. Contaminated oats can still trigger symptoms in some individuals.


Following a Gluten-Free Diet

There are three categories of foods to consider when planning a gluten-free diet:

  1. Naturally Gluten-Free Foods: Include vegetables, fruit, meat, fish, dairy, eggs, and certain grains like quinoa, cassava, rice, and buckwheat.

  2. Foods Prepared with Gluten-Free Substitutes: Many supermarkets and health food shops offer gluten-free options, including bread made from rice or potato starch flour.

  3. Processed Foods Labelled as Gluten-Free: Always check processed foods for hidden gluten, as it may not be apparent. Some flours made from naturally gluten-free ingredients may be contaminated during production.


Getting Gluten-Free Food on Prescription

Your GP can prescribe gluten-free foods, including bread, flour, and pasta. However, cakes and luxury-style biscuits are not included. Experiment with various brands and types to find what suits your taste and dietary needs.


Cooking Gluten-Free

Preparing meals from scratch is an excellent way to ensure a completely gluten-free diet. Enjoy Food offers a wide selection of gluten-free recipes to choose from. While cooking, take precautions to prevent contamination:

  • Wipe down kitchen surfaces.

  • Clean pots and pans thoroughly.

  • Consider separate bread boards for gluten-free and gluten-containing items.

  • Use a separate toaster or toaster bags.

  • Keep utensils and condiments separate to prevent cross-contamination.


In conclusion, managing coeliac disease alongside diabetes may seem daunting, but with careful planning and informed choices, it's entirely manageable. By adhering to a gluten-free diet and staying in close contact with your healthcare team, you can lead a healthy, fulfilling life while effectively managing both conditions. Remember that you are not alone—there is support and guidance available to help you navigate this journey successfully.

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