Coeliac and Type 2 diabetic

[Elaine333]

Hi I've been pre diabetic for a while but today a definite type 2 after blood test result. I was also also diagnosed as a coeliac at the same time over a year ago. Any advice please as to how to cope with the two often differing dietery requirements ? Feel I have to relearn what to eat again. Surgery have not been much help.

 

[rebrascora]

Hi and welcome.

Sorry to hear about your 2 diagnoses. As I understand it, Coeliac is an autoimmune condition associated with the body's reaction to gluten, so I would assume that a gluten free diet would be pretty compatible with a Type 2 diabetes diet in that most gluten is found in high carb grain products and those are the ones which will spike your BG. So avoiding those should help both the diabetes and coeliac.... but maybe that is a naive conclusion on my part.

I think the thing to understand with diabetes is that all carbohydrates break down into glucose and spike your BG levels. I know the NHS promotes wholegrains for Type 2 diabetes but many people here on the forum know from using their BG meter that our levels spike whether carbs are brown or white, so we avoid many of them altogether, instead basing meals on meat, eggs, fish, cheese, low carb veggies and salad with a small portion of berries as our fruit option. It may sound restrictive but actually it isn't and it can be very enjoyable once you get your head around it and start to experiment with different foods.

My other thought is that with coeliac being autoimmune, have they considered the possibility that you have Type 1 and not Type 2 diabetes. Type 1 tends to have a slower onset in mature adults, so it is often mistaken for Type 2 and some doctors just assume you must be Type 2 if you are not a child or young adult when you develop diabetes.

Anyway, just wanted to say a quick "Hello" and encourage you to ask about anything you don't understand. The forum is a gold mine of experience and knowledge and support, so "dig in" and make yourself at home.

 

[Inka]

Welcome @Elaine333 🙂 I echo @rebrascora about asking whether Type 1 has been ruled out. Regarding your diet, I’d concentrate on making sure the coeliac part was correct and then fit the diabetes in. There are plenty of foods you can eat eg meat, fish, eggs, beans, veg, fruit, and you could also look into small amounts of coeliac-friendly grains.

Take a look here for food info:

https://www.coeliac.org.uk/information-and-support/your-gluten-free-hub/food-and-drink-information/

.

 

[everydayupsanddowns]

Welcome to the forum @Elaine333

Sorry to hear about your double diagnosis. What a kerfuffle to have just got your head around one thing, then to be landed with another!

But we have several members who successfully balance multiple conditions - so hopefully you will be able to balance and juggle the requirements of both.

Perhaps it would help you to simply check your Coeliac-friendly menu to observe the impact on your BG levels, and make adjustments from there?

You can use a BG meter, taking a reading before and again 2hrs after eating, to see what the differences are to identify any carbs that seem to be spiking your BG. Ideally you would want to see a ‘meal rise’ of no more than 2-3mmol/L at the 2hr mark. Once you can see how you respond to different meals you can begin experimenting with reducing portion sizes of the carbs where you see bigger rises. You might find that you are particularly sensitive to carbohydrate from one gluten-free source (eg potatoes), but have more liberty with others (eg basmati rice) - It’s all very individual! You might even find that just having things at a different time of day makes a difference - with breakfast time being the trickiest.

But with a little experimentation, hopefully you can find a way of eating that is varied and enjoyable enough to be usable long-term, while also being helpful in the management of both your conditions.

If you need to self fund your BG meter, the most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 - which both have test strips at around £8 for 50

 

[Leadinglights]

I had a friend who was eventually diagnosed as coeliac after many years of being told it was all in her head that she was so unwell, but worked as a medical secretary and recognised her symptoms in something she was typing up. In those days there was little information about the gluten content in foods so it was trial and error as to what she could eat. There were some real oddities in that she was fine with courgettes but not cucumber, fine with plums but not apples. But even what she could tolerate was quite individual so a bit like diabetes in that the type of carb that some people will tolerate will be different to somebody else.
I think you may find the dietary requirements are not too dissimilar. Testing your meals will be hugely beneficial to enable you to make some good food choices.

 

[Elaine333]

Welcome to the forum @Elaine333

Sorry to hear about your double diagnosis. What a kerfuffle to have just got your head around one thing, then to be landed with another!

But we have several members who successfully balance multiple conditions - so hopefully you will be able to balance and juggle the requirements of both.

Perhaps it would help you to simply check your Coeliac-friendly menu to observe the impact on your BG levels, and make adjustments from there?

You can use a BG meter, taking a reading before and again 2hrs after eating, to see what the differences are to identify any carbs that seem to be spiking your BG. Ideally you would want to see a ‘meal rise’ of no more than 2-3mmol/L at the 2hr mark. Once you can see how you respond to different meals you can begin experimenting with reducing portion sizes of the carbs where you see bigger rises. You might find that you are particularly sensitive to carbohydrate from one gluten-free source (eg potatoes), but have more liberty with others (eg basmati rice) - It’s all very individual! You might even find that just having things at a different time of day makes a difference - with breakfast time being the trickiest.

But with a little experimentation, hopefully you can find a way of eating that is varied and enjoyable enough to be usable long-term, while also being helpful in the management of both your conditions.

If you need to self fund your BG meter, the most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 - which both have test strips at around £8 for 50

The diabetic nurse didn't seem to think I needed to test my glucose levels !?

 

[rebrascora]

Your diabetes nurse doesn't have to live with your diabetes meal by meal and worry that each thing you put in your mouth might be detrimental. She also likely has no idea about managing diabetes through diet and that it can be a more powerful tool than most diabetes medication. Sadly many GPs and nurses discourage people from home testing for a variety of reasons but here on the forum the vast majority of members who use their diet to help control their diabetes find a BG meter an invaluable tool when used with a structured testing strategy.... testing just before eating a meal and then 2 hours after to examine the impact that meal had on their levels and use that info to adjust their menu to suit their body's response to particular foods.

 

[Leadinglights]

I think that testing is particularly important if you have any conditions that may restrict what foods you can eat as it is going to be a matter of satisfying both the need to not aggravate that condition as well as managing your blood glucose level from day to day.

 

[Elaine333]

Your diabetes nurse doesn't have to live with your diabetes meal by meal and worry that each thing you put in your mouth might be detrimental. She also likely has no idea about managing diabetes through diet and that it can be a more powerful tool than most diabetes medication. Sadly many GPs and nurses discourage people from home testing for a variety of reasons but here on the forum the vast majority of members who use their diet to help control their diabetes find a BG meter an invaluable tool when used with a structured testing strategy.... testing just before eating a meal and then 2 hours after to examine the impact that meal had on their levels and use that info to adjust their menu to suit their body's response to particular foods.

Thankyou. I totally agree. At this early stage in my diabetes I have no real way of knowing if what I am eating is good for me, so have to guess and hope I've got it right. Especially when the information she gave was a bit vague and seemed to contradict what I had read on line. Eg. what fruits are high in sugar and what to avoid, even in small amounts.

 

[everydayupsanddowns]

Thankyou. I totally agree. At this early stage in my diabetes I have no real way of knowing if what I am eating is good for me, so have to guess and hope I've got it right. Especially when the information she gave was a bit vague and seemed to contradict what I had read on line. Eg. what fruits are high in sugar and what to avoid, even in small amounts.

Exactly @Elaine333!

This is a conversation that comes round again and again on the forum. People finding the idea of having actual information about how they react to different foods helpful, while their nurse or GP says this isn’t necessary.

Sometimes I wonder if the sorts of people we meet on the forum aren’t particularly representative of the ‘average’ person seen by a surgery nurse day to day? There certainly are clinical studies that show that people find BG monitoring painful, inconvenient, confusing and depressing - particularly if they have to stick to the ‘official’ diet they have been advised to eat, rather than using the results to adapt and personalise their food choices and portion sizes based on results they see on their meter.

Partly I think it must revolve around cost-savings. If Drs stress the importance of self-monitoring as a strategy, it would be very odd for them to refuse to supply the equipment.

Maybe there is only a small subset of people with T2, for whom this is such a helpful tactic - while the vast majority simply don’t want to be bothered with it and would rather simply take the tablets and try not to think about it? But it seems that the ‘small subset’ (which the clinical trials acknowledge) includes most people on the forum!

Hope you find it helps you too 🙂