Diabetes is a disease in which blood glucose levels, also called blood sugar, are above normal. As a result, the amount of glucose in the blood increases while the cells starve of energy. Glucose comes from food and is also made in the liver and muscles. Normally, the pancreas releases a hormone known as insulin into the blood, which is needed to convert sugar, starches and other food into energy for the cells. When the body does not produce or properly use insulin, glucose cannot get into the cells. Over the years, high blood glucose, also called hyperglycemia, damages nerves and blood vessels, which can lead to complications such as heart disease and stroke, kidney disease, blindness, nerve problems, gum infections, and amputation.
Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Some diabetes signs and symptoms include: frequent urination, excessive thirst, extreme hunger, unusual weight loss, increased fatigue, irritability and blurry vision. Genetics and environmental factors such as obesity and lack of exercise appear to play roles in the development of this condition.
Type 1 Diabetes:
Type 1 diabetes, formerly known as juvenile diabetes, is usually diagnosed in children, teenagers and young adults. In this form of diabetes, the beta cells of the pancreas no longer make insulin because the body’s immune system has attacked and destroyed them.
Health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes. In the OGTT test, a person’s blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.
A major goal of treatment is to control the ABCs of diabetes: A1C (blood glucose average), Blood pressure, and Cholesterol.
- Healthy meal planning.
- Physical activity.
- Medications used for diabetes: oral agents (pills) and insulin, which is used for type 1 diabetes.
- Routine testing of blood glucose.
The celiac implications of diabetes
There seems to be a link between type 1 diabetes and celiac disease. Some studies suggest that children with type 1 diabetes are more likely to have a subsequent diagnosis of celiac disease. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about 3-8 % of people with type 1 diabetes will have biopsy-confirmed celiac disease, thus individuals with type 1 diabetes would benefit from routine celiac disease screening.
Normally type 1 diabetes is diagnosed first because this type of diabetes tends to strike early in life and its diagnosis is certain. Also, celiac disease associated with diabetes is usually silent, showing no symptoms, and may only be found upon screening. Signs and symptoms, such as abdominal pain, gas, bloating, malabsorption, weight loss, and abnormal liver function tests may also be seen and easily confused with poor glucose control of type 1 diabetes or gastroparesis – when the muscles in the wall of the stomach do not function normally. Untreated celiac disease may also contribute to irregular blood glucose swings. Unexplained hypoglycemia, or low blood sugar, can be a sign of malabsorption related to celiac disease and should be investigated, particularly in small children. Both celiac disease and diabetes require dietary modifications for proper management, so the control or elimination of certain foods will keep the individual with either disease healthy.
- Celiac Disease, and Me!
An Introduction to Living with Both Diseases, June 2003
Kupper, C., Rinehart, J., Samuel, L., Jones, S. Diabetes
- American Diabetes Association
- Combining Diabetes and Gluten-Free Dietary Management Guidelines Practical Gastroenterology 2007: XXXI (3):68.
Kupper, C., Higgins, L.A
- The Seven Principles for Controlling Your Diabetes for Life
- National Diabetes Information Clearinghouse
- Juvenile Diabetes Research Foundation