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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to FREE Celiac.com email alerts What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet Free recipes: Gluten-Free Recipes Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.

Pre-Diabetic?
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I took it upon myself to do some at home glucose measurements, because I've had a candida infection that is basically unresponsive to treatment. The doctor has never looked for underlying causes-- the rheumatologist seemed to think I should bloody SUE for malpractice over this.

Anyway, my fasting blood sugar has pretty reliably come up at 93-95. This is on the high end of normal according to the ADA, but I've read in several places now that the ADA's numbers are way too high to begin with. I've read that their research and recommendations are paid for by bigAgra, so you can't really trust them. Should I be concerned?

Blood glucose monitors are also plus or minus 10%, so it could be 85, or it could be 105. One of which is normal, and one of which is definitely prediabetic. Thoughts?

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Ask your doctor for a fasting glucose and an A1C. Make sure you haven't eaten or drunk anything other than water for 12 hours before the test.

If you are pre-diabetic try to eat low glycemic index foods and cut your carb consumption.

Your rheumy can order the tests for you if you don't trust your regular doctor.

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I think that focusing on your blood glucose levels is a great way to tackle a stubborn candida infection. In my opinion, it is much easier to be concerned about and to remedy a blood sugar issue before it hits the ADA's idea of a problem. At the very least, using your meter to get some more information is a prudent things to do.

The meters aren't perfect, but they can show a consistent trend. If you prefer a more accurate meter, Dr Bernstein (Bernstein Diabetes Forum) currently recommends the Accucheck Aviva. His diet is very low carb and gluten free friendly. The forum is a great place if you have questions specific to blood glucose and there are several people with celiac and other food intolerances posting there.

But you may not need to get quite that far into it. For starters, getting a baseline A1c is fine, and you can use that opportunity to test your meter against your doctors.

But if you don't want to or can't see a doc right away, read one more page over at Bloodsugar101 - How to lower your bloodsugar:

How To Lower your blood sugar

It is basically a summary of Doc B's approach. You see, when your blood sugar is high is almost as important as how high it goes.

A fasting number indicates one thing, but you also want to see what happens:

right before you eat

and again 1 hour after the first bite of the meal

and again 2 hours after the first bite of the meal

So this is a lot of testing, and a manageable way to do it is to rotate though the week.

So on Sunday you test in the morning, which gives you a fasting #, and again 2 times after breakfast.

On Monday, you check before lunch and 2 times after

Tuesday, before dinner and 2 times after

Wednesday brings you back to breakfast

You'll be recording what you ate and noting exercise can help to. Snacking will cloud the picture, but if you do, just keep track of times.

You'll soon know if you need the pre-meal checks at all. You can then just check fasting once a week, but rotate it between weekdays and weekends for more accurate picture.

And you can see which meals or foods may be part of the problem, if there is one. in other words, this is a lot of trouble, but it is possible that your BG is reacting to just one food or food group. Even casein can raise your BG levels, but it may not ever spike them. In other words, BG responds to inflammation; food intolerances can cause inflammation even in the absence of the symptoms we usually notice, such as digestive distress.

If you decide to try this, feel free to post some of your meals and results here or to PM me or post over at Bernstein's - lots of help there!

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A fasting number indicates one thing, but you also want to see what happens:

right before you eat

and again 1 hour after the first bite of the meal

and again 2 hours after the first bite of the meal

Excellent advice. I did those checks myself at every meal and it was quite helpful in showing me what increased my BS the most.

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I second what ravenwood and rolling along said. The more data the better ;)And I am one who would agree that the ADA numbers are too high. Too many go undx that way and blood sugar issues are so much more easily managed with early intervention. The docs and I believe that I may have gone undx 10 years! I am officially a type 1, insulin deficient not resistant, most likely LADA also called type 1.5. I still make some of my own insulin and I can get 85 fasting without any meds or injected insulin. I was in that range on testing day. I was dx with an oral glucose tolerance test, but later on had antibody and other tests. The primary times my fasting goes up to or over 100, regardless of whether or not I use injected insulin to cover my meals, is when my allergy bucket gets too full or I am sick or I consume casein, to which I am allergic. I have about 20 food allergies. Individually they don't all impact my BG noticeably but the combo can and some individuals do. Following the methods and advice that rolling along gave I can have completely non-diabetic numbers, but if I eat fast acting carbs-grains, fruit, and starchy vegetables, I need some injected insulin. I can be 85 fasting or pre-meal and be up close to 300 after a meal-without mangement that is ;)That's why it's important to check not only fasting but post meal numbers as well-especially ones with fast-acting carbs. You can have diabetes and eat a low-carb meal or meal and not see high numbers so keep that in mind when you evaluate your results. Someone without diabetes will have steady, low numbers even after a load of carbs. I've tested famiy members just to see for myself ;)

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I used to eat a lot of rice but had to stop it. My BG was around 110 wen eating the rice but dropped back to 90's when I stopped it. I was waking up with cramps in my legs after eating rice so I figured that was the problem. I am going for a low carb diet and no sugar now. I think it's working.

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With pre-diabetes and even with full blown diabetes, you can have perfectly normal fasting BG (blood glucose) and even a normal A1c. When are you testing yourself? If you are typical and have BG issues, then your highest numbers would occur around 1 hour after eating. If you eat a high fat meal or have digestive issues like I do then your high number could come at the 2 or 3 hour mark.

What you should probably do is ask for the OGTT test. You will be asked to drink a sickeningly sweet drink and blood will be drawn three or more times to see if you are getting a spike.

You might also ask for a C-Peptide test. This will measure the amount of insulin you are producing. In my daughter's case, she didn't have overtly high BG. In fact her highest numbers were like yours. But she was producing almost as much insulin as I am as a full blown type 2 diabetic.

Are you seeing an Endocrinologist? If not, you should. The other Drs. my daugher was seeing said she was fine in the blood sugar department. She wasn't!

Another factor could be thyroid. If yours is low, it could in and of itself elevate your BG.

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I think the thyroid suggestion is an excellent one; but I think it is a little early for an OGTT and a c-peptide test. Unless you're seeing post meal data over 150 or so.

On the other hand, it is not too early to get on the waiting list to see and endocrinologist; it can take a long time to get an appointment!

An OGTT will tell you if you tolerate glucose, but you could pass that and still have a blood sugar problem caused by casein, or some other intolerance. My spouse passed his OGTT and his fasting numbers were much higher than yours, averaging 110.

Keep us posted, please!

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I think the thyroid suggestion is an excellent one; but I think it is a little early for an OGTT and a c-peptide test. Unless you're seeing post meal data over 150 or so.

On the other hand, it is not too early to get on the waiting list to see and endocrinologist; it can take a long time to get an appointment!

An OGTT will tell you if you tolerate glucose, but you could pass that and still have a blood sugar problem caused by casein, or some other intolerance. My spouse passed his OGTT and his fasting numbers were much higher than yours, averaging 110.

Keep us posted, please!

My daughter wasn't seeing high numbers but I am very glad she got the C-Peptide test done. She is on the max dose of Metformin now. And her A1c has come down.

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C-peptide is a useful test Julie. Glad that you have a clearer picture of where your daughter is at so she can get the treatment she needs.

I asked for it a few months after dx because I suspected that I had gone undx SO long and wanted to know where I stood. Eventually it was run twice and the results consistantly showed I was very insulin deficient, which helped clarify that I am a T1, not a T2 as I was originally dx. My numbers were high enough at times but not what the doc was used to seeing with either a T1 or T2. My presentation of diabetes was/is unsual.

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