Balancing Diabetes and Celiac Disease

Going to College with Autoimmune Conditions

| Jun 14, 2011

Max Bruno, a freshman at the State University of New York at New Paltz, tries to get to the gym about four times a week. He says that he knows his limits for working out, but likes to push himself.  "I just have to be careful," he explains. "About an hour or so after I'm done working out, my blood sugar drops really low."

Max was diagnosed with type 1 diabetes in January 2010. He found out after being tested for celiac disease, for which he also tested positive. "I'd been having stomach problems since the sixth grade," Max explains. "Frequent trips to the bathroom, throwing up, general pain, stuff like that."

An autoimmune condition, celiac disease is caused by an insensitivity to gluten. The term "gluten" encompasses all forms of wheat and some forms of rye, barley, and oats. As Max sardonically puts it, "If it tastes good, I probably can't have it." If left untreated, celiac disease can lead to other conditions, such as anemia. It remains unclear what role Max's celiac disease played in his developing diabetes.

Being diagnosed with one of the conditions would have been hard, Max says, but finding out he had both at the same time was brutal. "I was really angry. I just kept thinking, ‘Why me?'"

Max began using insulin pens after being diagnosed, but switched to a pump within a few months. Gluten-free foods typically have higher carbohydrate counts, which forces Max to use extra insulin in order to manage his blood glucose levels. "Since I switched [to the pump] last summer, I don't have to stick to such a strict eating schedule," he says. "I still have to be careful about what I eat, but it gives me more flexibility as to when I do it."

Unlike most of his peers, Max has to monitor everything he eats, a difficult task on a college campus. A typical day's diet at school includes gluten-free Rice Chex with milk at the dining hall for breakfast, a microwaveable gluten-free pizza for lunch, and then grilled chicken and vegetables for dinner.  "I snack a lot---crackers, fruits, gluten-free bagels, stuff like that," he says. "But I get really tired of eating the same things every day."

Having both conditions has obviously had a tremendous impact on how Max lives his life and how he views things. "Physically and mentally, I'm a completely different person than I was a year and a half ago. I'm way more cautious about things than I used to be. I have to be."

Max admits that it took him a while to adjust to having his conditions and that he still struggles with that. Aware of the consequences of neglecting his health, however, he is determined to live a normal and healthy life. "I think of it as a Venn diagram," he says with a smile. "There's the diabetes on one side, the celiac on the other. And I'm in the middle, trying to take care of both."

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Categories: Carbohydrate/Carbs,, Celiac Disease, College, Diabetes, Diabetes, Food, Gluten-free, Insulin Pumps, Low Blood Sugar, Type 1 Issues

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Posted by DAR on 14 June 2011

I don't have celiac disease, but I have diabetes and stay away from most grains to keep my BGL in the normal (nondiabetic range).

Gluten-free foods don't have to be high carb. I create low carb recipes and many of them are also gluten-free. You can find them through this link:

Posted by Anonymous on 14 June 2011

I'm having trouble posting here--so I'll try again--Max --hang in there. The studies show 1 in 9 type 1 diabetics also have celiac. There is a blood screening test so I encourage most if not all type 1's to ask your provider for the blood test. If that is positive, then you need the gi doctor to look in your stomach to confirm. I had no symptoms except a low vitamin D. Many type 1's have no symptoms, but untreated celiac can even cause cancers and malabsorption of elements we can't measure. Hang in there Max! I know it's hard and frustrating, but in the end the struggle is worth it--our health is our greatest wealth! peace and love, Jamilah

Posted by Anonymous on 14 June 2011

Hey Max,

Say the article. I am 25 year old with type 1 diabetes and Celiac Disease. After having diabetes for 15 years and Celiac for 3 I definitely know your struggles. However hang in there. Each day it seems that more and more 'healthy' gluten free products are coming out that are not loaded with the fat of older gluten free foods. If you have not tried them yet, I would suggest foods made by Udi's as they tend to not only taste better but are lower in carbohydrates and fat than many other gluten free foods.


Posted by jlnhjm on 14 June 2011

Max, I am a type 2, diagnosed in 1983 and have celiac, diagnosed in Jan 2001. Additionally, I am 73 years old and also have fibro. I know what you mean when you say brutal. Gluten is everywhere; it is nice that your school offers some gluten free foods, albeit, boring after a while.
You are young enough to have lots of energy to work out a plan for life. If you fall off the wagon, and a lot of us do, according to my gastro, and according to me, just view it as a lapse, and get back on.
I am glad to hear you are taking care of yourself, believe me, after time a lot of the changes you are forced into now, will become habit, making it a lot easier.
As to food: my advice is to eat lots of produce, especially veggies. When you eat that gluten free pizza, visit the salad bar first and ask if they will top it with ingredients found there, before heating it.
Now, I eat oats, a controversial subject amongst doctors. Try some, if you get a bellyache, you will know they are not for you. But if they are, you will have lots more choices for breakfast.
And don't forget the incredible, edible, egg, morning, noon and night, on different days, of course!
And I absolutely agree with Jamilah, health is unbelievably important and you must work on it always to assure you have an easier life.


Posted by Anonymous on 15 June 2011

hi max!! i am celiac and am being very carful to stay on a low suger diet asi can well become diabetic due to my family history. I totally understand that you are finging the diet boering as you keep eating the same foods over. However you are q great inspiration to me and to many keep it up and keep smiling!!

Posted by Anonymous on 15 June 2011

This article is very misleading and inaccurate.You are doing a disservice to your readers. I am a registered dietitian who was also diagnosed with celiac disease about 20 years ago. Please look at the University of Maryland Center for Celiac research web site. Facts: 1) Celiac is an autoimmune disease, not an allergy. You can outgrow an allergy, celiac is a lifelong condition that can be fatal if untreated. 2) There is a strong connection between celiac and type one diabetes. There is a much higher rate of celiac in type 1's vs the general population and vice versa. Much research has been done on this if you would have checked. All type ones should be screened for celiac 3) Research has shown that undiagnosed celiac disease damages the immune system and can cause a cascade of other diseases. Since he had problems since 6th grade, maybe if he were diagnosed and put on a gluten free diet he would not be type 1 right now. A hope for the future is if celiac disease is diagnosed more we will have less type 1. 4) Gluten free food can be delicious. I love my diet because it keeps me well.  Gloria Duy RD LDN OSF Saint James-John W. Albrect Medical Center Pontiac Illinois

Posted by Anonymous on 15 June 2011

I have had Diabetes since I was 8yrs old and about 3 years ago I found out I also have Celiacs. It was reassuring to hear about someone else that goes through the same thing on a daily basis and know that I am not alone :-) I had to laugh when Max said "If it tastes good, I probably can't have it", ha...that is about the way it goes. However, I have noticed more and more products that are advertised as gluten-free, here's hoping to more tasty gluten-free foods in the future! Thanks for the article Max!

Posted by celiac RD on 15 June 2011

This is a sad and inaccurate story. I am a registered dietitian and 20 year celiac. Please inform your readers with correct information. They can check out the University of maryland Center for Celiac research. 1) Celiac is not an allergy, it is an immune system disease that can be fatal if left untreated. People can outgrow an allergy. but celiac is a lifelong condition 2) ALL FORMS OF WHEAT< RYE< AND BARLEY are not allowed on a gluten free diet. Not SOME. Oats tend to be cross contaminated and only specially grown ones labed gluten free may be used. 3) There is a very strong connection between type 1 and celiac with a lot of research out there. The rate of type 1 is much higher in the celiac population and vice versa 4) Undiagnosed celiac can cause a cascade of other autoimmune diseases including type 1. Hope is that as celiac is more frequently diagnosed the rate of type 1 will go down. The man in this article obviuosly had celiac since childhood. If he were diagnosed maybe he would not be a type 1 5) Gluten free can be delicious. If he is only eating frozen pizza and junk food it is high carb. Gloria Duy RD LDN OSF Saint James-John W ALbrect Medical center, Pontiac Il

Posted by Anonymous on 15 June 2011

Max, I feel for you. I have celiac, and test my bg all the time because I'm obese. As a celiac we are suseptible to other autoimmune conditions. I recently got DNA testing which showed I'm more suseptible to Type 1 diabetes, lupus, and Sjogren's (less suseptible to RA, MS - and RA runs on paternal side). I have Hashimoto's thyroiditis already. Please look into the Paleo diet. And heed strictly to no dairy, no grains. After five years gf, and whittling away at dairy to only butter every other month or so, I learned I still have a leaky gut (and a milk fat protein, ie my butter, to blame). You won't be sorry. Be strict about it. Don't waste time like I did! You can do it!

Posted by Anonymous on 15 June 2011

Max, I feel for you. I have celiac, and test my bg all the time because I'm obese. As a celiac we are suseptible to other autoimmune conditions. I recently got DNA testing which showed I'm more suseptible to Type 1 diabetes, lupus, and Sjogren's (less suseptible to RA, MS - and RA runs on paternal side). I have Hashimoto's thyroiditis already. Please look into the Paleo diet. And heed strictly to no dairy, no grains. After five years gf, and whittling away at dairy to only butter every other month or so, I learned I still have a leaky gut (and a milk fat protein, ie my butter, to blame). You won't be sorry. Be strict about it. Don't waste time like I did! You can do it!

Posted by Anonymous on 16 June 2011

Diabetic (type 1), check, celiac disease check, went to New Paltz, check, so I can certainly relate to all. Also, to complicate my life and diet I chose to be a vegetarian (the only thing I really have control over). Things work out and life goes on. I sometimes visit New Paltz (it has been 25 years since graduation)and I always head to P&G's for a great salad. Good luck.

Posted by Anonymous on 16 June 2011

An insensitivity to gluten? Either sensitivity or intolerance, not insensitivity!

Eating lots of starches and commercial, processed gluten-free foods is going to cause problems. There are plenty of naturally gluten-free whole foods out there to fill up on. Don't spend your day eating GF junk food! Fruits, veggies, beans, nuts, seeds, lean meats if you're not veg, etc. in their natural form are all gluten-free!

pdw (gluten free, dairy free, vegetarian, multiple food allergies . . .)

Posted by antibody ninja girl on 12 October 2011

I am a Type I diabetic as well as having Celiac Disease. I have also been diagnosed with 4 additional auto immune diseases, and am currently undergoing GI testing for 2 other auto immune diseases. I am 28 years old and a mother of one son. The balance is definitely difficult. I am constantly creating and changing recipes to accomodate my dietary needs. I am curious if anyone else out there has any input, info, or research on such a complex combination. Please help. I blog at

Posted by Anonymous on 23 October 2011

I have diabetes type 1 and Crohn's desease. I would have been much more happier if I had Celiac instead of Crohns. haha

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