What to eat
By now you are wondering if there is anything that people with celiac disease can eat. Plain meats, fruits, vegetables, and most dairy products are all gluten-free, as long as they have not been breaded or cooked in the same pan with food that has been breaded. Likewise, corn, grits (made from corn), rice, potatoes, arrowroot, tapioca, beans, nuts, most soy products (except soy sauce), flaxseed, buckwheat (which is not actually a cereal but the seed of a flowering plant), sorghum, amaranth, quinoa, millet, and teff can be included in your meal plan. Packaged gluten-free cakes, cookies, waffles, pancakes, and pizza crust, as well as a wide variety of gluten-free baking mixes are available from specialty stores, some mainstream grocery stores, or from online or mail-order food companies. There are also bean, rice, and nut flours, which can be substituted in recipes that call for wheat flour. Mixing two or more types of flours when substituting for wheat flour gives the product a better texture. A gluten-free cookbook will give you tips for mixing flours and making conversions. These flours should be kept tightly sealed and stored in the refrigerator to prevent rancidity.
Since even a small amount of wheat, rye, or barley can set off a reaction, it’s important to keep foods strictly segregated in households where those who don’t have celiac disease consume those grains. If anyone in the household uses wheat flour in cooking or baking, be aware that it can remain in the air for up to 24 hours. It can also remain on hands that are not washed thoroughly. Cooking utensils that have touched foods containing gluten must be cleaned carefully before preparing gluten-free food. Difficult-to-clean items such as a flour sifter should not be used to sift both wheat flour and gluten-free flour. Even using a toaster that has crumbs from a piece of wheat bread can contaminate gluten-free bread.
When ordering fried food in a restaurant, be sure to ask whether any foods that have a breaded coating have been cooked in the oil your food will be cooked in. Request that your food be cooked in a separate pan to be on the safe side.
There are several national organizations that provide information on celiac disease and foods to eat or avoid. A list of these organizations is provided here. Joining a celiac support group in your area can provide you with emotional support, up-to-date information, and new meal ideas. Gluten-free cookbooks can help you find tasty recipes and provide you with tips on how to substitute gluten-free products in your favorite dishes. (See “For Further Reading and Information” for a collection of resources on gluten-free living.)
Celiac disease with Type 1 diabetes
In people with Type 1 diabetes, malabsorption of nutrients from undiagnosed celiac disease can lead to frequent, unexplained low or high blood glucose readings. Insulin needs are frequently lower during the time before diagnosis. Once treatment of celiac disease has begun and nutrients are better absorbed, insulin doses may need to be adjusted. Treating celiac disease should make it easier to keep diabetes under control. A study published in the July 2002 issue of the journal Diabetes Care found that in children with Type 1 diabetes and celiac disease, 12 months of a gluten-free diet not only improved their growth but led to a significant reduction in HbA1c level (indicating improved blood glucose control).