Gluten Free Diabetic

[sjpatt37]

Hello all!

I'd like to start out with a quick apology to the moderators. I did find a previous discussion on the topic, but, it was about two years old.

I was diagnosed as a Celiac about 18 months ago. I've got my foods pretty well dialed in, even sharing in a compromised kitchen.

My wife and I have had a friend come to live with us, who is Diabetic (adult onset, managed with glyburide and metformin) and has Celiac as well.

To make a (very) long story short, what I have is a guy who has not come close to eating as he should as a diabetic, yes, he's been good about sugar free, but not so great on choosing whole nutritious options for himself. This craptastic way of eating was brought on by the stress of his divorce and his really low self-esteem.

He was diagnosed Celiac in February 2012 and has been reluctant to get onto the gluten-free bandwagon (again, this ties back to his divorce and low self-esteem), also because he believes that he will have almost no decent food choices with the two diseases are combined.

(Please note: He was given 0 Nutritional Counseling with his IDDM Diagnosis)

I did tell him that prior to moving in with us, that I would help him to figure out how to be a gluten-free Diabetic.

I know that this can be done and as I read in the previous discussion, that the Celiac Diet has to prevail over the Diabetic Diet, due to the simple fact that gluten damage can be much longer lasting, while the sugars can be eliminated from the body much faster.

Fortunately, he is not much of baked goods sweets fan... Which is a great benefit.

Being a Celiac myself, I know that most of the things that I eat are already fairly diabetic compliant...

I could be oversimplifying things to say that once I can get him to 100% gluten-free, that striking the balance for his nutritional needs should come in fairly easy..

So, I could really use your collective knowledge and wisdom in this case to make sure that I am assisting him in the best way possible.

I especially want to hear from other gluten-free Diabetics regarding your most favorite snacks that hit low on the Glycemic Index that can be kept around the house and given pretty freely.

I would also, like to let everyone know that my wife has agreed already to let go of the compromised kitchen that we have and shift it to 100% gluten-free for the safety of our housemate.

[psawyer]

I'm a bit confused. You initially speak of his diabetes as "adult onset, managed with glyburide and metformin." But later, you refer to IDDM.

IDDM is an initialism for Insulin Dependent Diabetes Mellitus, also know as type 1, or autoimmune. This form of diabetes is linked statistically with celiac disease. It can not be treated with the drugs you mentioned--they can only be used to treat type 2 diabetes.

[Jestgar]

Peter, maybe while we're waiting for the OP to return, you could give a briefing on what the different diagnoses mean for someone who is also gluten-free. It seems like it might be handy to have a description of different eating options, and if there is are any big red food flags for type 1 vs type 2.

[sjpatt37]

I am probably using wrong terms.

In which case, I am sorry and any further education on diabetes would help me tremendously.

In the meantime, let me get a bit more specific on the knowledge that I have on hand. This may even help all of you to lend me a hand too.

Diabetes in this case is Adult Onset, due to weight.

Originally, he was on insulin injections, as he lost weight, he was able to shift to the glyburide and metformin.

I have come to learn that while he is good at testing his blood sugar, he's not good at charting it.

(This will have to change, so that in the event of an emergency, I have information handy to give to medical personnel)

I have noticed, that he is not good at snacking and often waits until he is very hungry to eat... rather than eating as his body needs it.

Also, he is pretty horrible at hydration and often waits until he is dehydrated and then gulps water down.

I am aware that the items above can have a pretty big impact on a diabetic.

[missy'smom]

So much to address,

As for the confusion about terms- adult onset type 1's can and are often treated with meds and no insulin or small doses of insulin or just one type of insulin at first. The sulphonyurea(sp?) class of drugs just burns out insulin producing cells quicker. Some adult onset T1's have some insulin resistance and take metformin and others don't. Some are DX with no or next to no beta cell function but some have a fair amount of beta cell function left at dx and can make enough of their own insulin to help out a fair amount depending on how they are managed. Adult onset T1 is often slower progressing than child-onset T1. I have adult onset autoimmune type 1. I still produce enough of my own insulin that I can eat a low-carb meal and not take a shot or take a small dose if I eat fast acting carbs.

The glycemic index is bunk in my experience. It does not match up with blood sugar impact at all. Low carb is what works. You want to find low-carb options.

Your diabetes management questions would be better adressed to a diabetes forum, there are many who are gluten-free on them. There is a Facebook group specifically for LADA, ot T1.5 or autoimmune adult onset T1, whichever name you choose, they are the same. Many there are gluten-free. Many are low-carb friendly and can provide links and good resources in the D community towards heathly numbers and choices.

You have to be careful about how you talk about dietary management and be careful not to judge the food choices of a diabetic. Many T1's are told that they can eat anything they want as long as they cover it with insulin. Many diabetics are told they have to eat a certain amount of carbs at each meal and even many time told to eat more than they would otherwise or more than non-diabetics eat. What you and I know to be healthy and what diabetics are taught by their docs are often very much at odds. If you try to tell a diabetic what they should or should not eat and you don't have diabetes, then they have their trusted docs saying another thing, what result do you imagine? I'm not criticizing you. It's just a delicate situation. Tread carefully and gently.

Many diabetics are told that quite high, unhealthy numbers are ok too.

A person should never choose between gluten-free and diabetes. There is absolutely no reason to put gluten-free "first" or to not have food that doesn't work for both. High blood sugar is very damaging to tissues and will burn out insulin producing cells in he body if a person has some at dx.

[missy'smom]

To be blunt,

to me personally,

the term "diabetic diet" makes no sense at all. Never has. There is not one set plan that all diabetics follow. Everyone eats as differently as the mainstream population does. The "diabetic" recipes, dishes in restaurants are somewhat loosely based on the idea that diabetics should eat low-fat and maybe some whole grains snuck in there and so many carbs per serving. But they are by no means necessarily "healthy" or better for a person that regular foods.

So many docs even get mixed up between advice for T1's and T2's. It's crazy.

The gluten-free diet had clear rules and they are the same for everyone but diabetes is not that way. It is VERY individual. Diabetes is VERY individual, people have different levels of pancreatic function/ability to produce insulin and how the body is able to manage that insulin. People have different activity levels, metabolisms, weigh issues, lipid profiles and other metabolic balances/imbalances, all of which affect blood sugar, diet and management.

[missy'smom]

Please don't misunderstand either, I'm not giving you a hard time.

google low carb or low carb diebetes or low carb gluten-free

Lots of sites with recipes for using flax or almond meal as the only "flour" in baked goods, that are both gluten-free and low-carb and easier, although pricier;), than the usual gluten-free baking.

Many LADA's are mis. dx as T2 and/ or not properly treated at dx because so many docs still have nver heard of it or are not familir with treating it. They are so used to T2's.

In my experience, being mis dx as T2 at 77 lbs! plenty of fats and low carbs and plenty of protein helped me get some more weight back on while maintaining healthy blood sugar levels. Crispy bacon instead of potato chips

[GFinDC]

Hi,

Divorce is no fun. I understand if he is depressed because of it. Some diabetics do follow a low-carb diet, which almost amounts to no carbs in some cases. They stick to meats and nuts and non-starchy vegetables. With maybe a small amount of carbs as a "treat" occasionally. This diabetes forum link may help him. There is a chat option at the top of the forum where you can chat live with other people. It's a real friendly group. There are some that don't trust their doctors (tongue in cheek) for some reason, same as here. We all have learned tor be our own health advocates.

Open Original Shared Link

There are various diets around that might suit him. Like the paleo diet, or variation of it. A god way to start the gluten-free diet is by sticking to whole foods like meats, veggies, fruits and nuts, Fruits might be a problem for him though. Cooking all meals from scratch using whole foods is a great way to go. Not eating processed foods or limiting them is good. He may have problems with dairy at first. In that case not eating it for 6 months may resolve it. Damage to the gut can be healed but it takes time.

Testing blood glucose an hour and 2 hours after eating (post prandial) is helpful. Some people react with higher numbers soon after eating and others it takes a while.

Many members have reported depression form glutenings also. Gluten can affect any part of the body including the brain. Avoiding gluten may lift the depression after a while.

Some threads that might help.

FAQ Celiac com

http://www.celiac.co...uestions-about-

celiac-disease/

Celiac Newbie Info 101

http://www.celiac.co...ewbie-info-101/

What's For Breakfast Today?

http://www.celiac.co...-for-breakfast-

today/page__pid__726053__st__180#entry726053

What Did You Have For Lunch Today?

http://www.celiac.co...or-lunch-today/

What Are You Cooking Tonight?

http://www.celiac.co...ooking-tonight/

[psawyer]

Individual diabetic cases vary. In true Type 1--whether late onset or not--the autoimmune reaction destroys the cells in the pancreas that create insulin. Since the body no longer produces insulin, insulin injections are usually required multiple times per day.

In type 2, the pancreas produces insulin, but the body resists it. The drugs mentioned above help the body use the insulin it has. They "unlock" the cell's door for the insulin.

Hypoglycemia (low blood sugar) is a concern for both types, but much more so for type 1.

Type 1 patients must consume carbs to balance the insulin they take. Taking protein at the same time slows the digestion. Certain carbs are absorbed more quickly. Simple sugars, such as those in fruit juice, are absorbed quickly through the stomach lining. More complex carbs have to break down, and are absorbed in the small intestine.

For a newly diagnosed celiac, the difference in types of carbs is important. Prio to my celiac diagnosis, I was having frequent problems with hypoglycemia. Sometimes after a meal, my blood sugar would drop instead of rising.

Nobody spotted the pattern at the time, but in hindsight it was obvious--and should have been a big red flag for celiac disease. If I ate only complex carbs, my blood sugar failed to rise--my small intestine was just not absorbing them.

Many people with diabetes experience improved blood sugar control once their celiac disease is under control, as the malabsorption stops being a factor. During the recovery phase, dosage changes may be needed. Better absorption may lead to higher blood sugar levels.

Meal timing and planning vary in flexibility depending on the types of medication and/or insulin. The oral drugs used to treat type 2 diabetes offer less flexibility than injected insulin.

I am currently on a combination of two insulin types. This combination allows me considerable flexibility. I take Lantus daily at bedtime. It is a basal insulin with a 3-hour onset and 24-hour duration after that. By taking a standard amount at approximately the same time every day, it provides a flat action level, sustained all day, every day. With my meals, I take Humalog. It has a very rapid onset, and a short duration. Because of this, I do not need the between-meal snacks that many diabetics require. The dosage can be varied with the carb content of the meal.

One thing to watch for: In many cases, substitute gluten-free products have a higher caloric (and glycemic) content than their "regular" counterparts.

Modern thinking on the diabetic diet is different from what it was years ago. Many things which used to be forbidden are now permitted, provided that the quantities are controlled along with the frequency of consumption. It is not so much what you eat today, as what you eat every day. In my case, an occasional sweet treat (balanced with extra Humalog at the time) will not be a problem.

[missy'smom]

I'm sorry, in re-reading your post I am a little confused about which type he is. He looks more like T2 now- when you said due to weight, I first thought of too much weight loss= low weight, undesired weight loss at DX which is common with T1, however if he was a bit overweight or the weight loss was good for him then he sounds like a T2. T2's make enough insulin but their bodies don't use it effectively. They can also burn out their insulin producing cells with high blood sugar over time. T2 is a very different metabolic thing than T1 so it is important to know which. The advice for dietary management can share things in common with T1 but can also sometime be very different. Both type 1 and type 2 can have adult onset.

[sjpatt37]

Wow! Thanks for all the great responses!

I do not feel that anyone is picking on me at all. In fact, you are all helping to educate me!

This, is priceless... I never turn down an opportunity to learn.

His divorce has been really hard on him and he admits to eating only sugar free jello, cereal, chicken noodle soup and ginger ale.....for the last 8 months.

You are right, I can't/shouldn't condemn him for that or criticize it.. It's hard because people can't live on a diet that is just that and keep their health in the right place.

I know he did it because of the divorce and the depression that goes with a heart hurt like that. Sadly, until we moved him into our house, he lived 3,000 miles away from me. So, I couldn't really go over to his house and cook him a good solid meal or have him come to mine.

But, he lives with us now... which means, we can be there to support him as he works to manage both and educate him.

For me and my house we are a whole foods, cook at home and as few processed/high chemical foods kind of home. It is what made my going gluten-free easy and I am not likely to give up that kind of habit that we created.

I would like to think, that having that kind of food habit, would help him in both cases.

He is a T2 - Diabetic.

I have several friends and family members who are diabetic, but, I have never shared a house with any of them, so I have had minimal exposure to how they balance their foods out daily. Each of them do have different attitudes about managing their diabetes.

One has "I am going to eat anything I want and just take as much insulin as I need to counteract it"

One has "I am going to try my hardest to not take my insulin at all,because I hate giving myself shots"

The rest "My insulin is a tool, it helps me to survive"

They have all told me that being Diabetic and gluten-free are impossible.... I didn't want to believe that, so I came here.

Having a diabetic in my house, really means that I want to be cautious and considerate to his food needs too and I really want to understand how to help him to manage gluten-free and T2 at the same time.

You are all most likely very right and that I should also consider posting the same questions to a diabetic forum too.

We do become our own biggest health advocates especially once we all come to understand our own nutritional needs and how our bodies relate to the foods we eat.

[psawyer]

"My insulin is a tool, it helps me to survive"

Close. My insulin doesn't help me survive, it enables me to survive. Without insulin, I would have been dead 25 years ago. I had been an insulin dependant (type 1) diabetic for fifteen years before somebody figured out that I also had celiac disease. It was not a health care professional who figured it out. It was my dear wife, who was searching online and found something on the Canadian Diabetes Association site about celiac disease. She printed it out, and when I came home from work that day, she showed it to me and said, "Peter, all your symptoms are here." I got tested, and she was right.

You absolutely can be gluten-free and eat a diet suitable for a diabetic. I have been doing it for almost twelve years. There are many others on the board who deal with both celiac disease and diabetes.

[sjpatt37]

To ALL of you who took the time to respond. I cannot thank you enough.

I sat down with my housemate and was able to have a really good long talk that started with:

"Do you remember that I promised I would find out more information on managing Diabetes and Celiac at the same time? Well, I did some research, joined up with the forum at celiac.com, and this is something we can do!"

The conversation stayed positive.

We agreed that we need to sit down together and talk about what he has been told his requirements should be and how to help him meet his goals.

We agreed that a little more diligence with charting his blood sugar and possibly pairing with a food diary will help him get started.

During the course of our conversation, he asked me loads of questions about my foods and whether or not I ever feel deprived of foods.

I did tell him that while I never feel deprived, I do occasionally miss the convenience. That it does get frustrating having to be aware constantly.

But it gets easier and the frustration seems like nothing in the face of being sick for days.

He admitted that he's been resistant to gluten-free, because he was so afraid it would leave him with so little to eat.

Fear is something I can understand and respect. I understand it much better than a "don't want to, can't make me" attitude.

I hope that we can continue to discuss this and that you will continue to teach me.

[Juliebove]

I'm a diabetic. Diagnosed as an adult but take 2 meds and 4 kinds of insulin. IMO, weight doesn't cause diabetes. But the precursors to diabetes, such as Syndrome X can and most likely will cause weight gain. It's sort of like the... Which came first? The chicken or the egg?

That being said... There is no one diet that we all follow.

There are plenty of diabetic who follow a low carb diet but then there are also plenty who don't. I don't. Because I can't. But I have additional medical issues.

The main thing is to find a diet that is not only nutritionally sound but one that doesn't spike his blood sugar or cause lows. This can be easier said than done.

Also, sugar isn't the culprit with diabetes. It is carbs. And yes, sugar is a carb but it is technically no worse in terms of blood sugar than some other foods like white bread (yes, wheat I know), tapicoa bread, white rice, potatoes, etc.

Also, fat delays the absorption of carbs. So a little fat in a meal is a good thing. Too much fat can be bad because then whatever carbs were eaten could come into the system too late and a hypo (low blood sugar) can occur. Simply eating carbs by themselves is warranted if there *is* a hypo, but as a meal can be a very bad thing. This can cause a spike in blood sugar, followed by a low which is referred to as reactive hypoglycemia.

So the best meal for a diabetic would contain some carbs, plenty of fiber, a goodly amount of protein and some fat. But how many carbs? Ah, there's the rub. Some of us can eat more carbs than others. My dad and brother who are both larger than me, seem to be able to eat a lot more carbs than I do. A very active person might be able to eat more carbs. For me? 2 to 3 servings per meal is my limit.

In general terms, whole grains are better than the more refined foods. So brown rice would be better than white. Brown rice pasta or pasta made with quinoa and/or corn would likely be better than white rice pasta. But... Each body is different.

If the diabetic can get enough test strips then it is best to test before eating, then two hours after eating. Some people also test at the one hour mark. If their numbers are in range (that range should be decided upon between the diabetic and their Dr.) then those foods and proportions are what they should be eating. If their numbers are too high, then they need to cut back on the carbs some more.

Some people can not tolerate carbs very well at all or find that some carbs work better for them than others. Beans are one such example. They contain protein and are high in fiber. So they do seem to work well for a lot of diabetics.

My daughter is pre-diabetic as well. So for us, I find the easiest way to satisfy us is to make meals that are one dish things. For instance... Tomorrow I will make enough Spanish brown rice for two days. It will use a pound of browned ground beef, a green pepper and a red pepper chopped, a white onion, chopped, a can of chiles and about a 1/2 cup of salsa. If I had any other tomatoes or tomato product in the fridge that I wanted to use up, I would add that too. I might also add more pepper and onion. The key is to add as much protein and non-starchy veggies as I can. I will then lightly brown a cup of uncooked brown rice in a small amount of olive oil, then add the ingredients and about 3.5 cups of water (I am using Texmati rice, others might require a little less water), bring to a boil, reduce the heat to low, cover and cook for about 45-50 minutes then let sit for about 5 minutes or until any excess liquid is absorbed. This is enough food for us for two meals each. And we eat it with some refried beans. Doesn't spike my blood sugar and my daughter only knows that she is eating rice, which she loves. She doesn't realize that I cut back on the amount of rice that I put in it. You could even cut back further on the amount of rice that you use. That would be fine too.

If I am making a casserole, I put in more of the protein and non-starchy veggies and less of the starchy stuff. I find that green beans and wax beans work well in casseroles.

For soups, I either make them only with protein and non-starchy veggies, or I add very little in the way of potatoes, corn, peas, pasta, rice, etc.

It is possible for a diabetic to dine out. Even eat fast food. They just have to make wise choices. The biggest burger with a huge amount of fries is never a wise choice. And you may have to ask for things to be served differently than what they are on the menu. At Wendy's you can now get a sweet potato. It comes with a brown sugar butter. But you can ask for that to be left off and get plain butter. Their chili is a fine choice. So is a side salad or any of their other salads so long as they don't have breading on the meat. A small order of fries would be fine if there aren't a lot of other carbs in the meal.

At a regular restaurant, a burger can always be ordered without the bun. That's how I always get it. Yes, some places have gluten-free buns but they are often higher in carbs than the regular buns and probably don't taste so good. You can even get just hamburger patties at fast food places. Most restaurants will sub in extra cooked veggies or sliced tomatoes or even some cottage cheese (if they have it) for the potatoes or the other starch on the plate. It is also possible to order side dishes. A cup of fresh fruit, a chicken breast, a dinner salad...

[Jestgar]

His divorce has been really hard on him and he admits to eating only sugar free jello, cereal, chicken noodle soup and ginger ale.....for the last 8 months.

For me and my house we are a whole foods, cook at home and as few processed/high chemical foods kind of home.

Gonna be like getting whapped upside the head with a board for him. :ph34r:

[sjpatt37]

Gonna be like getting whapped upside the head with a board for him. :ph34r:

Hahaha!! Yes, I suspect that you are right. With minimal convenience foods hanging around... It's going to be a shock to the system.

[sjpatt37]

Gonna be like getting whapped upside the head with a board for him. :ph34r:

You say that like it's a bad thing....

I promise not to whack him really hard with one.

[GFinDC]

You say that like it's a bad thing....

I promise not to whack him really hard with one.

Just be patient. People do need some time to adjust to the idea of gluten free and diabetes on top. It sure sounds like your house is a good environment for him to learn how to eat right though. I've experimented with making some sugar free candy before, using stevia to sweeten it. I haven't reviewed these recipes for diabetes friendliness issues, but they might work.

Open Original Shared Link

Open Original Shared Link

Open Original Shared Link

[sjpatt37]

We try really hard to keep our house very food safe.

He's still very resistant to being gluten free, he's paid the lip service to it.. Then, when I tell him something has gluten in it he then says "I know, I don't care." and then whines about his reaction. (which has gone from mild to extreme)

Since my wife and I have shared a compromised kitchen with great success, up to this point. She decided last night was the last night of that.

It's very much "Lead a horse to water" situation right now.

[MelW11]

I just want to say that you and your wife are wonderful people to let a friend who is going through a horrible time and has health problems move in with you. Good job on trying to get educated and help him out!

[sjpatt37]

I just want to say that you and your wife are wonderful people to let a friend who is going through a horrible time and has health problems move in with you. Good job on trying to get educated and help him out!

Thanks!

This isn't going to be without it's challenges, beyond food stuff. (That's just the thing I can best manage)

This morning, the previous very positive conversation that I had with him about Celiac, was blown completely out of the water.

Since arriving at our house, all he could talk about was how much he wanted pizza, from a particular place.

He goes to visit his mother and when he gets back to our house(last evening), he tells me that she bought that pizza, from that pizza chain that he wanted so bad and bread sticks.

This morning, he can barely walk, his body hurts from head to toe and his belly hurts. (wonder why?)

(we won't talk about the other side effects he is having... we can probably all tick them off on our own fingers)

Admittedly, I lost my patience. Especially, when he is whining and giving me the "I don't care." statements.

A little bit of tough love was required, maybe I was too rough, but my response was "You'll care when you have to have a bowel resection"

I understand the fear, I understand how tough it seems navigating the gluten-free waters right away.

I respect it... but, it's hard to be constantly patient when someone doesn't want to comply.

I am spending a good portion of my day working on the Compassion aspect. Since I feel guilty for losing my patience.