Being gluten-free is popular among people looking to improve their health. For example, people with celiac disease should avoid gluten, while others choose to avoid foods that contain gluten.
Does it make sense for people with type 1 or type 2 diabetes that do not contain gluten?
In this article, we will dig deep into gluten. Do what it is, where it is, the signs and symptoms of gluten-related issues, and what research on gluten and diabetes is saying.
What is gluten?
According to the Celiac Disease Foundation, “gluten is the common name for protein found in wheat, rye, barley and tritikale. It is the intersection of wheat and rye.” Gluten provides elasticity to the dough, helping to rise during baking and maintain its shape. The two main proteins found in gluten are called gliadin and glutenin.
What foods contain gluten?
Gluten is found in foods made with wheat, barley, rye and Tritikare. Or it contains ingredients made from these grains. Note that there are also a variety of wheat varieties, including wheat berries, durum, emer, farro, graham, semolina, and spelling.
The commonly eaten foods that have gluten are:
- Wheat-based foods: Bread, cereal, pasta, couscous, flour tortilla, crackers, cakes, cookies, pastries, seitan, wheat gluten.
- Rye: Rye bread, rye crackers, and some cereals (e.g. Eden organic rye flakes).
- barley: Soups containing malt, malt extract, malt milk, malt vinegar, beer, barley, brewer’s yeast.
In addition to these foods, gluten is found in many ingredients and additives. For example, you can make coloring, flavoring, starch and adhesives with grains that contain gluten. These ingredients are added to processed foods such as sauces, gravy, soups, salad dressings, hot dogs, ice cream and candy.
How about oats? Oats are naturally gluten-free. However, if they are grown in the same facility as wheat, rye, or barley, or processed in the same facility, they can be cross-contaminated. If you need to avoid gluten, look for oats labeled gluten-free.
What is celiac disease?
Celiac disease is a chronic digestive and autoimmune disorder that damages the lining of the small intestine. This disease is caused by eating gluten-containing foods. Celiac disease is extremely serious as it prevents the absorption of nutrients from food, and can lead to many serious health conditions, including:
- malnutrition
- anemia
- Vitamin and mineral defects
- Heart disease
- Liver damage
- Osteoporosis (weak and brittle bones)
- Nervous system problems (headaches, balance problems, peripheral neuropathy)
- Reproductive problems (miscarriage, infertility)
In rare cases, celiac disease can lead to small bowel cancer and non-Hodgkin’s lymphoma.
Celiac disease affects an estimated 2 million people in the United States. This is about one in 133 Americans. Many people with this condition have not been diagnosed.
Symptoms of celiac disease
Symptoms of celiac disease can vary widely and can go back and forth. Digestive symptoms are common and may include:
- Bloody
- Chronic diarrhea
- gas
- constipation
- Pale, unscented stool
- Lactose intolerance
- Nausea and vomiting
- Stomach pain
However, symptoms are not limited to the digestive tract. Some people with celiac disease may not have digestive symptoms, but they may present:
- Fatigue
- Joint or bone pain
- Weight loss
- Depression and anxiety
- Mouth symptoms (dry mouth, ulcer pain)
- Dermatitis Herpetofolifolis (itritic rash with blisters)
- Numbness and tingling in the legs
How is celiac disease diagnosed and treated?
Celiac disease is usually diagnosed through a combination of medical history, physical examinations, blood tests, and small intestine biopsy.
Blood tests are used to search for antibodies produced by the immune system in response to gluten. It is also used to check for health issues that may be associated with celiac disease, such as iron deficiency anemia.
In some cases, blood samples or swabs are made to collect cells from within checks to look for specific genetic variants called DQ2 and DQ8. Having these genetic markers indicates an increased risk of celiac disease, but those tests do not confirm a diagnosis of this condition.
The “gold standard” for the diagnosis of celiac disease is a biopsy of the small intestine during upper gastrointestinal endoscopy, says the Celiac Disease Foundation. Samples of the small intestinal lining can then be studied under a microscope to look for damage and inflammation caused by celiac disease.
If celiac disease is confirmed, treatment adheres to a strict gluten-free diet to cure the lining of the small intestine.
A gluten-free diet means avoiding all food and non-food products, including some gluten-containing medications, supplements, personal health products, and cosmetics. It is essential to carefully read product labels and ingredient lists.
There are no medications to treat celiac disease, but there are no treatments at present.
What is gluten sensitivity?
Gluten sensitivity (also known as non-celiac gluten sensitivity or gluten intolerance) is not the same as celiac disease. Both conditions involve gluten problems and can cause digestive symptoms, but gluten sensitivity is not an autoimmune condition and does not cause damage to the small intestine.
There are no diagnostic tests for gluten sensitivity, but rather are determined based on symptoms and negative diagnosis of celiac disease and wheat allergy.
Not all health experts agree that gluten is the perpetrator of gluten-sensitive symptoms. For example, it could be caused by low-fermentable, short-chain carbohydrates (fermentable oligos, di and monosaccharides, polyols, or, for short, non-gluten components of wheat.
Symptoms of Gluten Sensitivity
Symptoms of gluten sensitivity may vary from person to person, but the most common symptoms are changes in stomach pain, bloating, and/or intestinal patterns, according to the American Academy of Allergy, Asthma and Immunology (AAAI). Some people have other symptoms, such as:
- Fatigue and weakness
- headache
- Joint or muscle pain
- Skin problems
- “Brain Fog” (difficult to concentrate or memory problems)
- Numbness or tingling in the hands and feet
If you have any of the above symptoms, it is important to let your healthcare provider know so that you can take the test and get the appropriate diagnosis and treatment. A gluten-free diet may help relieve symptoms and/or perhaps provide a low-fodmap diet.
Is gluten harmful to people who are not celiac disease or gluten sensitive?
Celebrities, athletes, social media influencers, and even some healthcare professionals declare the benefits of a gluten-free diet, but the reality is that many of these benefits are not beneficial.
One small study involving adults without known disabilities compared high-gluten and low-gluten diets. A low-gluten diet led to moderate changes in microbiome, leading to improved self-reported bloating. However, researchers attribute it to changes in dietary fiber intake.
There is no conclusive evidence that gluten consumption is harmful if you are not celiac disease, gluten sensitivity, or wheat allergy. The gut microbiota is actively studied, and gluten can affect the microbiome, but further research is needed in the final study.
For people who do not have celiac disease, gluten sensitivity, or wheat allergies, gluten does not damage the digestive tract. A gluten-free diet is not necessarily healthier than a gluten-containing diet and does not necessarily lead to weight loss.
Eliminating healthy gluten-containing foods from your diet can mean missing out on healthy whole grains, fiber, vitamins and minerals. Also, many processed gluten-free foods are high in calories, sugar, fat and sodium, which can lead to weight gain, blood glucose fluctuations and high blood pressure.
If for any reason you need more information about a gluten-free diet, talk to a registered dietitian (RD).
What are the research on gluten and type 1 diabetes?
Most studies on gluten and diabetes are related to type 1 diabetes. This is because type 1 diabetes and celiac disease share certain genetic markers.
Environmental factors also play a role. The introduction of gluten-containing foods into infant diets and viral infections have been implicated as a potential trigger for both celiac disease and type 1 diabetes.
Like celiac disease, type 1 diabetes is an autoimmune disorder characterized by the destruction of pancreatic beta cells (cells that produce insulin). People with type 1 diabetes are at a higher risk of developing other autoimmune disorders, including celiac disease.
Celiac disease affects about 1% of the world’s population, but according to a study published in the March 2022 issue of the journal, it can affect about 5% of people with type 1 diabetes. Curette. Other studies suggest that the prevalence may be higher.
Because people with type 1 diabetes are at a higher risk for celiac disease, the ADA recommends that adults with type 1 diabetes undergo screening for celiac disease in the presence of gastrointestinal symptoms, signs, laboratory symptoms, or clinical suspicion suggesting celiac disease.
What are the research on gluten and type 2 diabetes?
Regarding type 2 diabetes, the relationship between gluten and celiac disease is not particularly strong. This is because type 2 diabetes occurs due to a combination of genetic, lifestyle and environmental factors, while type 1 diabetes and celiac disease are both autoimmune states.
Studies that increase the risk of type 2 diabetes with gluten is somewhat contradictory. Below are some studies that investigated the possibility that a gluten-free diet may reduce the risk of type 2 diabetes.
- A study published in 2021 suggests that foods containing gluten may affect the composition and function of the gut microbiota in the context of metabolic disorders such as type 2 diabetes.
- A review study published in 2018 concluded that “evidence of the mildew effect of gluten-free diets is more uncertain, especially with regard to the small number of human studies conducted.” The authors note that animal studies have reported improvements in both obesity and type 2 diabetes in a gluten-free diet, but few studies have been conducted in humans.
However, there is some evidence that gluten-containing diets can actually reduce the risk of type 2 diabetes.
- According to a survey published in the journal in 2018 Diabetesin three large prospective cohort studies of American men and women, high gluten intake during the 20-28-year follow-up period reduced the risk of type 2 diabetes. The authors of this study concluded that “gluten intake at the level of consumption, normally seen in Western populations, is not a risk factor for type 2 diabetes.”
Obviously, more research is needed to better understand the relationship between foods containing gluten and the risk of type 2 diabetes.
Final Thoughts
If I have type 1 or type 2 diabetes, should I avoid eating gluten?
- For type 1 diabetes: If you have symptoms that suggest celiac disease or gluten sensitivity, first discuss with your health care provider to determine whether you should get tested. Depending on the outcome, if you have celiac disease, you may need to follow a gluten-free diet. If you don’t have celiac disease but you may be gluten sensitive, it may be helpful to try a gluten-free diet to alleviate your symptoms.
- Risk of type 2 diabetes or type 2 diabetes: Currently there is no good evidence to support a gluten-free diet. Of course, let your provider know if you have symptoms that suggest celiac disease or gluten sensitivity. Keep in mind that these symptoms may also be related to other conditions.
- For the general population: For those who do not have celiac disease, gluten sensitivity, or wheat allergies, eliminating gluten from their diet is unlikely to provide health benefits, and can lead to miss out on important nutrients found in whole grains.
If you decide whether you need a gluten-free diet, consult a registered dietitian, ideally a dietitian with experience with celiac disease or gluten sensitivity. Keep in mind that not all gluten-free foods are healthy, and many of them are more carbohydrates, fats and sodium than the “regular” version.
Finally, if gluten is not your concern, focus on choosing less refined carbohydrate foods from whole grains instead of highly processed, refined carbohydrates. Overall, these foods have excellent blood sugar, weight, blood pressure and gut health, and may help reduce the risk of chronic disease.
Do you follow gluten-free diets? Try our delicious gluten-free recipes.
