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:

  • Wheat,
  • 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.

 

 

Causes:

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.

 

 

Diagnosis:

In order to properly diagnosis Celiac Disease, individuals MUST be consuming gluten at the time of testing.

    1. Bloodwork Screening evaluating the IgA-ttG antibody
    2. Small Intestinal Biopsy for a definitive diagnosis

Treatment:

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.

 

 

Cross Contamination:

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.

 

 

Symptoms:

 

People with Celiac Disease can present with a variety of symptoms which may appear suddenly or gradually over time.

 

  1. Typical Symptoms:
  • Chronic diarrhea
  • Abdominal pain
  • Unexplained weight loss
  • Malabsorption (especially of iron, folic acid and/or Vitamin B12
  1. Atypical Symptoms:
  • Anemia
  • Osteoporosis
  • Extreme fatigue
  • Oral ulcers (i.e. canker sores)
  • Constipation
  • Infertility
  • 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!

 

  • Wheat
    • Einkorn
    • Emmer
    • Farro
    • Kamut
    • Spelt (Dinkel)
    • Wheat bran
    • Wheat germ
    • Wheat starch
    • Hydrolyzed wheat protein
    • Beer, ale, lager
    • Fu
    • Freekah
    • Farina

 

  • Barley
    • Malt
    • Malt extract
    • Malt vinegar
    • Malt syrup
    • Malted barley & malted barley flour
    • Malted milk
    • Miso

 

  • Other
    • Rye
    • Bulgar
    • Triticale
    • Oats, oatmeal, oat flour & oat bran – unless specifically labeled gluten free
    • Breading & bread stuffing – includes breaded meat, fish, poultry
    • Groats
    • Brewer’s yeast
    • Dextrin
    • Graham flour
    • Atta (chapatti flour)
    • Seitan
    • Matzoh
    • Couscous
    • Durum
    • Semolina (pastas)
    • Soy sauce, teriyaki sauce & Worcestershire sauce – unless specifically labeled gluten free
    • Broths, soups & stocks – unless specifically labelled gluten free
    • Licorice
    • Ovaltine® (chocolate malt & malt flavours)
    • Smarties®

 

 

References (information & pictures):

 

https://www.celiac.ca/

 

https://nationalceliac.org/

 

https://celiac.org/

 

https://www.beyondceliac.org/celiac-disease/

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