Having diabetes and celiac presents some unique challenges for carb counting and absorption. As a person with diabetes, I learned how to judge the number of carbs in everything I ate through a combination of reading package labels, learning portion sizes and trial and error with insulin dosing. Once Celiac Disease was added into the mix, I had to learn entirely new carb counting skills. Many gluten free breads, crackers, cookies are higher in carbs and fat than their gluten filled counterparts. Because fat affects absorption speed and insulin sensitivity a whole new dose is necessary for those two gluten free cookies you enjoyed after dinner.
The average slice of white gluten bread has 80 calories, 0 grams of fat and 16 grams of carbohydrates. Gluten free bread can range from 110 to 170 calories for one slice. Yikes! I was diagnosed with diabetes at 11 years old, yet two years ago I had to relearn something that had become second nature.
To add to the confusion, one of the side effects of Celiac disease can be severe damage to the intestinal villi. Those are the little finger-like things that line your intestines and absorb food, nutrients etc. Well, as your body begins to heal on the gluten free diet your villi slowly start to absorb again. But it happens erratically and at different rates. That means that, assuming all other factors are equal, you can eat the exact same thing two days in a row, give the same insulin and still get wildly different blood sugar results.
That can lead to quite a bit of frustration with two diseases that require constant management and vigilance. What’s the point of trying when you just can’t get it right? Luckily I have an amazing endocrinologist. She helped me to understand that there was only so much I could do while I was healing and I couldn’t beat myself up over something over which I had no control.
Two years later, my antibodies are finally down to “undetectable” and my current 14 day blood sugar average is at 110! It’s still a constant learning process but I finally feel like it’s manageable.
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