Diabetes and Celiac Disease (Part 3)

This week, I’ll wrap up my three-part series on celiac. So far, we’ve looked at symptoms of celiac, how it’s diagnosed, and the beginnings of what the gluten-free diet consists of.  I’d like to share some more information on the gluten-free diet, since this is really the crux of the treatment of celiac, as well as some tips for managing both diabetes and celiac at the same time.


I’m also curious to know how many of you have celiac. If you have celiac and you have some helpful hints or tips that could help others, please share!

Gluten-Free Diet Tips
Last week, in “Diabetes and Celiac Disease (Part 2),” I listed the grains that are “forbidden” when following a gluten-free diet. And while things can seem pretty restrictive, it’s good to know that there are a lot of foods that you can still eat.

I attended a session at AADE (the diabetes educators’ conference) back in August on celiac, given by a dietitian who has both diabetes and celiac (and who knows her stuff, I might add!). Something she mentioned was new to me: A “safe” amount of gluten is about 50 milligrams (mg) of gluten per day. That may not mean anything to you. However, to keep things in context, a one-ounce slice of wheat bread contains about 4,800 mg of gluten. So, if you want to splurge on wheat bread yet still be safe, you could eat a 100th of a slice of bread!

My point is that while it’s impossible to totally avoid gluten altogether, it’s important to do your best to avoid gluten-containing foods as much as possible if you have celiac disease. Some people may think, “I feel fine—what can it hurt to eat a slice of bread/a small dish of pasta/a piece of pizza, etc.?” Herein lies the danger. You may feel great, but when you have celiac, even very small amounts of gluten can wreak havoc on your intestinal villi, causing damage.

We’ve already reviewed some of the complications associated with untreated or poorly treated celiac. This list of complications, unfortunately, includes a higher risk of cancer. So, don’t be lulled into a false sense of security. If you have celiac disease, stay as gluten-free as possible!

About 90% of processed foods contain gluten, so become an astute label reader. Watch out for these ingredients, as they often indicate that the food contains gluten:

  • Hydrolyzed vegetable protein or vegetable protein (unless made from corn or soy)
  • Flour or cereal products
  • Malt or malt flavoring
  • Modified starch or modified food starch (unless made from corn, potato, or tapioca)
  • Vegetable gum (unless type of gum is specified and is gluten-free)
  • Soy sauce

Distilled vinegar is okay to use, but malt vinegar isn’t. That means, too, that malt beverages (e.g., beer) are not okay. Good news—Redbridge beer is gluten-free. Oatmeal may be safe, but you need to be sure that it is not contaminated with other grains.

There are a lot of intricacies to the gluten-free diet, and they’re beyond the scope of this post, so it’s a good idea to work with a dietitian who ideally has some experience with celiac and to read as much as you can about it.

Celiac and Diabetes
If you have diabetes and are wondering if you might have celiac, please get tested. Besides the more “traditional” symptoms, you may notice unpredictable or unexplainable swings in your blood glucose; hypoglycemia a couple hours after a meal; hypoglycemia that is hard to treat; and lack of improvement in your HbA1c level. Of course, these diabetes symptoms can be due to other causes, but, they could be linked to celiac.

Finally, know that there are a lot of resources out there for folks who have celiac. Here are a few to get you started:

There are also many food companies that specialize in gluten-free products. The above Web sites will give you names and links to these companies. And don’t forget to check out your local grocery store/health food store for gluten-free products, too.

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  • Smithbrother

    I have both type two diabetes and Celiac. I was dianoised approximately two years ago initally by a skin biaopsy. I was 58 at the time I was dianoised but had been having symphems and problems for two years previous.
    The hardest thing I find in purchasing food is the “Modified food starch”; I wish that the law would require labling which would state the source of that starch ,as I must avoid all foods that state it unless it specifies the source ,such as from Corn.
    This removes almost all of the soups from a can and many , many other processed foods. I have even gone so far as to contact One of the major food prepration companies and my experience had not been fairable. They went so far as to state that if it contained gluten they would have to list it. My experence is that she was either not telling the truth or was ignorant of the subject.
    Thank you.

  • Deodatta Bendre

    I read with interest about Gluten-Celiac disease. Could you comment on Gluten intolence?

  • acampbell

    Hi Deodatta,

    Symptoms of gluten intolerance include gas, bloating, abdominal pain and diarrhea. These symptoms are triggered by eating foods that contain gluten. Gluten intolerance isn’t the same as celiac disease, though. Celiac occurs when the gluten affects the immune system and actuallly damages the villi in the small intestine. Celiac can also lead to malabsorption of important vitamins and minerals, and in some cases, can lead to deficiencies of these nutrients, which, in turn leads to more serious health problems. Both gluten intolerance and celiac are treated with a gluten-free diet. Anyone who has recurring gastrointestinal symptoms should be evaluated by a physician, since these symptoms may be due to conditions other than gluten intolerance or celiac.

  • RAWoodward

    About the same time I was diagnosed with diabetes, I developed two other conditions. My upper abdomen began to swell and become sensitive to pressure. I experience cramping if even light pressure is applied, and the abdomen produces a hollow “thump” if tapped, like a ripe watermelon. Accompanying this was nausea and intermittent diarrhea alternating with constipation. This was diagnosed and treated as IBS with mixed results. The bowel conditions come and go, although the bloating and sensitivity to pressure are constant. I also developed a rash of intensely itchy bumps (tiny ones) on my shins, calves, and occasionally my waistline. This was diagnosed as “sensitive skin” and was treated with steroid cream. Although the itching and bumps gradually subsided, the rash -along with very dry, flaky skin persists on my shins. This has been several years now. I’ve never been tested for Celiac. Should I be? And is this something that a group of very competent doctors (which I believe I have) would tend to overlook?

  • acampbell

    Hi RAWoodward,

    Your gastrointestinal symptoms do seem consistent with IBS, which can be difficult, at times, to manage. But it’s interesting that you also have a skin condition which could possibly be dermatitis herpetiformis (and my disclaimer is that I’m not a physician, so I can’t diagnose you) and which is linked to celiac. I would definitely discuss the possibility of celiac with your physician, given your diabetes, and ask to be tested, starting with a blood test. At the very least, you can rule out celiac if results come back negative.

  • jsteele

    Have been type 1 diabetic for 44 yrs – 2 yrs ago went on an insulin pump – it has “saved my life”….as I was having severe insulin reactions without being able to feel symptoms of hypoglycemia. I also developed celiac 6 yrs ago –
    specifically DH – dermatitis herpetiformis. Doctors treated the intensely itchy rash all over my body with cortisone creams and injections. It provided great relief but made my blood sugars soar and crash. I didn’t understand why my BS control had gone crazy – it was the cortisone -and several doctors had no idea their remedy was the culprit. Once I started going gluten free,I saw a dermatologist and was placed on a high dose of Dapsone for 2 yrs to control the rash but still continued to suffer sudden severe hypoglycemic events. I learned that Dapsone is a sulphonylurea antibiotic that cleared up my rash but can cause hypoglycemia. At a time when I was so ill I depended on all the doctors to prescribe the right medications to me. Its important to know your medications before you take them. Discuss them with your doctor, and a pharmacist will be able to clarify and give additional information.

  • tradeguy

    i believe i toohave celiac and diabetes
    one thing i been trying is raw brocolli and cauliflower and psylium i throw them in the blender and my vitamins and spiralin and eye support and nerve support and soy bean powder oh a cayeenne pill. probiotics, acidicous flora stuff
    i let it jell or swallow it down the cayeenne is spices the other things up .,.
    i was thinking the little a diabete eats of flour anyway the psyllium fiber could just flush the grains out out protecting te villi,, you can but theat psyllium in wallmart or health sore for 6 – 8 dollars take it three times a day with your meals. and way with the blood sugar control you use in the mix ,, i was use the diabete resistance starch mix .,when i found out it is equal to the psyllium as a fiber instead of the 70 dollar a week powder IM mix my own powder soy with vitamins etc,, howeveri have to buy some cinamom bark inaddition to the soybean powder

  • gluten free diet

    When I was first diagnosed it was really hard to make the change b/c gluten is in everything, but over time it has gotten a lot easier. One great benefit it I’m a lot healthier, I feel it daily. I’m not tired anymore and I don’t have all those lingering symptoms – there gone! Make the change and stick with it, your body will thank you later, I promise.