Avoiding gluten might seem to be just a dietary rage, but a gluten-free diet is not a fad if you are gluten intolerant or have celiac disease. And if you have diabetes in addition to celiac disease, figuring out what to eat can seem like a monumental task. Learn some helpful tips and tricks to make managing celiac (or gluten intolerance, which is treated like celiac) and diabetes a little easier.

What is celiac disease?

Celiac disease is a disorder that damages the small intestine. Eating foods that contain gluten, a type of protein, will trigger a digestive reaction. If you have celiac disease, you need to avoid foods that naturally contain gluten, such as wheat, barley and rye, including bread, pasta, cookies and cakes. In addition, gluten is found in many pre-packaged foods. You might be surprised to know that gluten is an ingredient in many non-food items, such as lip balms and lipsticks, hair and skin products, toothpastes, dietary supplements, and even some medicines.

Why do you need to avoid gluten if you have celiac disease?

If you have celiac disease and eat a food that contains gluten, the body launches an immune response that can damage villi in your small intestine. Villi are finger-like structures along the lining of the small intestine that help with nutrient absorption. If the villi are damaged, nutrients aren’t absorbed properly and that can lead to malnutrition, osteoporosis, anemia, infertility, epilepsy and certain cancers. At this time, the only treatment for celiac disease is to avoid gluten.

How to eat healthfully with celiac disease and diabetes

Following a gluten-free diet can seem challenging, especially when it means giving up certain foods, such as wheat-containing bread, pasta, cereal and pizza. It can also be overwhelming to realize that you have to avoid gluten while also trying to keep your blood sugars in a safe range. Here are some tips to get you started:

• Learn as much as you can about a gluten-free diet. It can help to meet with a dietitian who can work with you to set up an eating plan that is both gluten-free and diabetes-friendly.
• Focus on what you CAN eat, rather than foods that you have to avoid. You may be pleasantly surprised to find out that there are many foods that you can still enjoy: fruits, vegetables, meat, poultry, fish, nuts, seeds and Milk and yogurt are, for the most part, gluten-free, but here is where you need to read the ingredient list carefully. Cabot, Chobani, Fage, and Stonyfield Farm (except YoToddler Plus Fruit & Cereal) are brands of yogurt that are gluten-free. Be especially careful with yogurts with add-ins – most granolas are not gluten-free.
• Go for other carbs. Wheat, rye, and barley contain gluten, so they’re off limits. But brown rice, quinoa, millet, amaranth, corn, sorghum and buckwheat groats are gluten-free. Oats are okay as long as they are labeled gluten-free.
• Count carbs. Gluten-free carbs are safe for your celiac disease, but they can still impact your blood sugars. Other carb foods affect blood sugars, too, such as fruits, milk, yogurt and Talk with a dietitian or your doctor about carb counting and how much carb to aim for at your meals and snacks.
• Always read the ingredient list. Food manufacturers can change ingredients in their products, so unless a food is labeled gluten-free, make a point to read the ingredient list on every food item that you buy (assuming it has a food label, of course). Many candies – like licorice – are wheat-based. And don’t forget to read labels on vitamins, toothpaste, cough drops and medicines, too. And remember that “wheat-free” is not the same as “gluten-free.”
• Rethink your kitchen. If you share a kitchen with others, use a separate toaster, flour sifter, and cutting board. Consider buying separate containers of butter, margarine, cream cheese, mayonnaise and peanut butter if you share food with others. That way, no gluten-containing crumbs will get mixed in.
• Try out gluten-free Baking isn’t off-limits if you have celiac disease. A number of flours are now readily available that don’t contain gluten, including rice, tapioca, coconut, millet and sorghum flour. Bob’s Red Mill, Arrowhead Mills and King Arthur are brands that carry gluten-free flour. Again, keep in mind that gluten-free doesn’t mean carbohydrate-free: keep track of your carb intake if you’re enjoying gluten-free bread, pancakes or cookies. Use a smartphone app, such as Calorie King or My Fitness Pal, to look up the carb content of your foods if they don’t have a label.
• Eat out with ease. Eating out when you have celiac disease is easier these days, thanks to more restaurants offering gluten-free dishes. However, to be on the safe side, do your homework if you’re planning on dining out. Check out the menu ahead of time to make sure there are safe options for you. Better yet, call the restaurant ahead of time to ask about gluten-free entrees. You’d be surprised at what items aren’t gluten-free, like french-fries (potatoes, naturally gluten-free) which are battered (wheat) before frying. When you’re at the restaurant, let your waiter or waitress know that you can’t eat gluten. Don’t be afraid to ask questions, either; for example, find out if the salad contains croutons or if gluten-free items are prepared and cooked separately.
• Keep tabs on your blood sugars. There are a lot of adjustments to make if you are new to a gluten-free diet. You’ll probably need to change the types of foods you are eating, and this can affect your blood sugar levels. Check your blood sugars more often than usual until you feel more comfortable with a gluten-free diet. Work closely with your doctor to tweak your diabetes medicines if your A1C or blood sugar levels are consistently above or below your target range.

For more information about celiac disease and the gluten-free diet, visit:

• Celiac Disease Foundation: celiac.org
• Gluten Intolerance Group: gluten.org
• Gluten-Free Living: www.glutenfreeliving.com