Tips for managing both celiac disease and Type I diabetes

Mariah Kay Jackson
Can you offer any tips for managing both celiac disease and type I diabetes?

Answer


People with Type 1 diabetes (T1DM) are at an increased risk of developing celiac disease (CeD), and both conditions involve understanding food choices for optimal management (1). Fortunately, there are food choices that help promote a healthy lifestyle for both.

Grains: Understanding both T1DM and CeD involves understanding grains. For T1DM, it is important to understand serving sizes of carbohydrates (carbs) to be able to appropriately dose insulin (learn more about carb-counting through the American Diabetes Association). For CeD, one needs to know how to read labels to identify gluten-free (GF) grains or other gluten-containing ingredients. For both, choosing GF whole grains, rich in fiber, vitamins, and minerals can support your health. Make ¼ of your plate GF whole grains like brown rice, quinoa, buckwheat, or stone-ground corn/grits. Look for fortified GF cereals and whole grain GF breads and pastas.

Fruits: The Dietary Guidelines for Americans (3) recommends eating about 2 cups of fruit per day for adults, or about ¼ of your plate. Fruit is naturally GF and is a wonderful source of fiber, vitamins and minerals! For those with T1DM, it is important to know fruit is a carbohydrate food and should be counted for insulin dosing.

Vegetables: Non-starchy vegetables like leafy greens, carrots, broccoli, peppers, and summer squash are great choices to brighten your plate! Non-starchy vegetables typically do not have to be counted for carbohydrates for T1DM, but starchy veggies like peas, winter squash, corn, and potatoes should be. Starchy or not, these veggies provide great sources of nutrients and should make up ¼ to ½ your plate, or about 2-4 cups per day.

Dairy/Dairy-Alternatives: Calcium and vitamin D are very important nutrients we can get from dairy products. If choosing a dairy alternative, be sure to check the label to make sure it is fortified with calcium and vitamin D and is low in added sugars. Soy milk is the most similar to dairy milk, being high in protein, compared to almond or rice milk, which are generally low protein. For T1DM, milk and yogurt should be considered carb-containing foods; the amount of carbs in milk-alternatives will vary by the source (ex. almond milk vs rice milk).

Protein sources: ¼ of your plate should be a protein source. Naturally GF proteins include eggs, meat, fish/seafood, beans, and nuts. Note for T1DM, beans or other legumes like lentils, would be a carb food source. For CeD, lentils and dried beans may have a risk for cross-contact with gluten-containing grains; it is important to look through them when washing and soaking.

Take home message: The key to successful management of both CeD and T1DM is label reading to understand both what foods are GF and what foods have carbohydrates. Eating a variety of fruits, vegetables, and GF whole grains are healthy choices for both. Talk with your doctor or dietitian to personalize these recommendations to you!

  1. Goodwin G. Type 1 Diabetes Mellitus and Celiac Disease: Distinct Autoimmune Disorders That Share Common Pathogenic Mechanisms. Horm Res Paediatr. 2019;92(5):285-292. doi:10.1159/000503142
  2. American Diabetes Association. Accessed October 2023. Carb Counting and Diabetes. https://diabetes.org/food-nutrition/understanding-carbs/carb-counting-and-diabetes
  3. Dietary Guidelines for Americans. Accessed October 2023.  https://www.dietaryguidelines.gov/

Published November 7, 2023

Note: This information is provided by NCA and Mariah Kay Jackson, MMN, RDN, LMNT. This information is meant for educational purposes only and is not intended to substitute for personalized medical advice or replace any medical advice provided directly to you by your health care provider. No liability is assumed by the NCA or Mariah Kay Jackson, MMN, RDN, LMNT by providing this information.

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