Celiac Disease & Diabetes
What is Celiac Disease?
Celiac Disease is a hereditary autoimmune intestinal disorder in which the absorptive surface of the small intestine is damaged by gluten. Gluten is the collective name given to the proteins found in:
- Barley &
- Rye or triticale
When an individual with Celiac Disease ingests gluten, an immune reaction is triggered causing damage to the finger-like projections, called villi in the small intestine. As a result, the body is unable to absorb nutrients from food appropriately.
Autoimmune disorders occur when the body’s immune system has a difficult time differentiating between its own, healthy cells & foreign cells (i.e. viruses) causing the body to mistakenly attack normal cells.
Celiac Disease occurs commonly in those with other autoimmune disorders such as type 1 diabetes & thyroid disease or liver disease. The connection however, is not completely understood.
- Approximately 5-8% of people with type 1 diabetes will develop Celiac disease
- Approximately 2-5% of people with thyroid disease will develop Celiac Disease
Celiac Disease can also run in families, both in first & second degree relatives (e.g. parents, siblings, grandparents, aunt/uncle, etc.). Therefore, screening for high risk individuals should be considered.
5-22% of people with Celiac Disease have an immediate family member who also has Celiac Disease.
The development of Celiac Disease involves a combination of genetic, environmental & immunological factors. It can present at any age & may be triggered by an infection, severe emotional stress, pregnancy, childbirth or surgery.
In order to properly diagnosis Celiac Disease, individuals MUST be consuming gluten at the time of testing.
- Bloodwork Screening evaluating the IgA-ttG antibody
- Small Intestinal Biopsy for a definitive diagnosis
There is currently no cure for Celiac Disease. The only treatment at this time is a strict gluten free diet for life.
Those with Celiac Disease need to be vigilant about hidden sources of gluten & cross contamination in food products which requires careful label reading.
People who need to eat gluten free need to check both the ingredients in food and any cross-contamination with gluten-containing ingredients that might happen when the food is manufactured, packaged and prepared for eating. Crumbs matter when considering cross contamination!
Tips to Avoid Cross Contamination:
- Use separate butter dishes, toasters & cutting boards used for gluten free food only
- Ensure the space you are using to prepare gluten free food is freshly washed
- Do gluten free baking first & have it well wrapped & stored before preparing food with regular flours
- Thoroughly scrub any pots or utensils that are used for other foods before using to prepare gluten free foods
- Be careful when shopping out of bulk bins as they can easily be contaminated by using the scoops in more than one bin
- Be cautious of purchasing meat at the deli counter. Gluten free meats may be cut using the same utensils without cleaning in between as non-gluten free meats
- Be cautious of buffets
- Avoid foods fried in oil where non-gluten free battered foods have been fried
- Read labels for hidden gluten in medications or cosmetics
It is recommended that people with Celiac Disease choose grains, cereals & flours that are clearly labelled “gluten free” as they are at high risk for cross contamination.
People with Celiac Disease can present with a variety of symptoms which may appear suddenly or gradually over time.
- Typical Symptoms:
- Chronic diarrhea
- Abdominal pain
- Unexplained weight loss
- Malabsorption (especially of iron, folic acid and/or Vitamin B12
- Atypical Symptoms:
- Extreme fatigue
- Oral ulcers (i.e. canker sores)
- Lactose intolerance
- Bone/joint pain and/or muscle cramps
- Itchy, blistering rash (dermatitis herpetiformis)
- Neuropathy (inflammation of nerves)
Gluten-Containing Foods & Ingredients:
Please note that this is not an exhaustive list!
- Spelt (Dinkel)
- Wheat bran
- Wheat germ
- Wheat starch
- Hydrolyzed wheat protein
- Beer, ale, lager
- Malt extract
- Malt vinegar
- Malt syrup
- Malted barley & malted barley flour
- Malted milk
- Oats, oatmeal, oat flour & oat bran – unless specifically labeled gluten free
- Breading & bread stuffing – includes breaded meat, fish, poultry
- Brewer’s yeast
- Graham flour
- Atta (chapatti flour)
- Semolina (pastas)
- Soy sauce, teriyaki sauce & Worcestershire sauce – unless specifically labeled gluten free
- Broths, soups & stocks – unless specifically labelled gluten free
- Ovaltine® (chocolate malt & malt flavours)
References (information & pictures):