Coeliac disease 16 March 2020 This week is Coeliac Awareness Week (13 – 20 March). It’s a condition that impacts around 5% of people living with type 1 diabetes. Why not take some time to learn about living with diabetes and coeliac disease? The National Diabetes Services Scheme have produced this fantastic fact sheet. Coeliac disease is a condition where the lining of the small intestine is damaged due to sensitivity to a protein in food called gluten. Gluten is a protein found in grains such as wheat, rye, oats, barley and triticale. Coeliac disease and diabetes may occur together and is more common in people with type 1 than type 2 diabetes. It is estimated that up to 5% of people with type 1 diabetes may have Coeliac Disease. Symptoms of coeliac disease The following symptoms are often associated with coeliac disease: Diarrhoea Streatorrhoea (floating, fatty stools) Loss of weight Abdominal bloating or distension Flatulence How is it diagnosed? If you think that you have coeliac disease, you should first approach your doctor. A medical history and an examination will be performed and, if thought necessary, further tests will be undertaken to help diagnose the condition. You may be referred to a specialist. If Coeliac Disease is suspected, a gluten free diet should not be started until the condition is properly diagnosed, otherwise this will interfere with the correct diagnosis. The gluten free diet should always be undertaken with medical supervision. Treatment A gluten-free diet is currently the only known treatment for Coeliac Disease. Gluten-free foods include corn, rice, sago, tapioca, buckwheat, potato, soy, arrowroot, fresh fruit, vegetables, meat (except most processed meats), poultry, fish and most dairy foods. Foods with gluten Grains, wheat, rye, oats, barley and triticale, processed foods with ingredients such as wheaten corn flour, wheat starch, malt, malt extract, malt dextrin and the thickeners 1400 to 1450, all contain gluten. If you are diagnosed with Coeliac Disease, gluten containing foods must be avoided along with products made from these foods. This includes many breads, cereals, biscuits, cakes, scones, pizzas, pies and processed foods. The Coeliac Society of Australia produces a booklet that lists ingredients and their suitability for a gluten-free diet. All people with Coeliac Disease should obtain a copy of this booklet. Importance of not eating gluten If coeliac disease is left untreated, your chance of developing other medical problems increases. Even if you are eating gluten and not experiencing symptoms, damage to your intestine can still occur. Untreated or inadequately treated coeliac disease can lead to your body not being able to properly absorb essential nutrients from food such as iron and calcium. It can also lead to difficulty in controlling your diabetes. Healthy eating for diabetes & coeliac disease For those who have diabetes and coeliac disease, healthy eating includes: Regular meals and snacks containing gluten-free carbohydrates Foods that are low in saturated fat Plenty of fruit and vegetables If you have been diagnosed with diabetes and coeliac disease, it is recommended that you see a dietitian with expertise in coeliac disease for specific advice about developing an eating plan that’s right for you. Importance of carbohydrate foods Carbohydrate foods are the best energy source for your body. When digested, they break down to form glucose in the bloodstream. Eating regular meals and spreading carbohydrate foods evenly throughout the day, may help maintain energy levels without causing large rises in your blood glucose levels. If you take insulin or certain diabetes tablets, you may need to eat between-meal carbohydrate snacks. Discuss this with your dietitian or Credentialled Diabetes Educator. For more information Contact the Coeliac Society of Australia.