Are You Thinking About Eating Gluten-Free?
While celiac disease is a recognized medical disorder, some celebrities and popular diet books have demonized gluten, making gluten-free diets trendy for people with no medical reason for the restriction. “It’s caused a bit of hysteria,” says Pam Cureton, RD, a dietitian at the Center for Celiac Research in Baltimore and chairperson of Dietitians in Gluten Intolerance Diseases.
Some people incorrectly associate gluten-free with low-carbohydrate. Shoppers see “gluten-free” on packaging and assume anything labeled free of something must be better. Often, however, the gluten-free food is lower in nutrients and higher in sugar, saturated fat, and sodium, making it a poor choice for most people—especially for those with diabetes.
Celiac Disease and Gluten Intolerance: What’s the Difference?
Celiac disease, a chronic autoimmune intestinal disorder, affects about 1 percent of the general population, but it is more common among people with type 1 diabetes. Celiac disease is characterized by intestinal damage, nutrient deficiencies, joint pain, severe fatigue, weakness, and infertility. Some people, however, have no obvious symptoms at diagnosis.
Gluten sensitivity is more common than celiac disease. “It affects about 6 percent of the population,” Cureton says. These individuals do not have intestinal damage, so they will not suffer nutritional deficiencies, she says. However, a gluten-free diet is required to manage their symptoms, which may include joint pain, debilitating lethargy, gas, bloating, diarrhea, and foggy brain. The only current treatment for both celiac disease and gluten sensitivity is a strict, lifelong gluten-free diet.
The Gluten and Diabetes Connection
Celiac disease is 5-7 percent more common in people with type 1 diabetes than in the general population. Both are autoimmune diseases and may have a similar genetic basis.
“A person with type 1 diabetes should be fully tested for celiac disease and gluten sensitivity prior to starting a gluten-free diet,” says registered dietitian Rachel Begun, a spokesperson for the Academy of Nutrition and Dietetics. Diagnosis of celiac disease requires an intestinal biopsy to see how gluten affects the intestine. Thus, regular gluten ingestion is necessary for accurate results.
“If celiac disease is ruled out through testing, gluten sensitivity is evaluated by tracking symptoms when removing and adding gluten back into the diet,” Begun says.
Celiac disease is not more common among people with type 2 diabetes than in the general population.
“Type 2 diabetes is not autoimmune in nature. To date, there is no research to show a connection between type 2 diabetes and gluten intolerance,” Begun says.
The American Diabetes Association recommends screening children for celiac disease shortly after the diagnosis of type 1 diabetes. Unexplained nutrient deficiencies and poor blood glucose control might be signs, Begun says. Celiac disease damages the intestine and affects nutrient absorption, sometimes without causing symptoms. Erratic nutrient absorption can cause erratic blood glucose and frequent low blood glucose. If you have these symptoms, talk to your physician about being tested for celiac disease.