Gluten Free Diabetic

[shadowedsensei]

Greetings to the Forum,

I'm hoping that someone out there can help me. I am the resident manager for an adult family home in western Washington state. Very recently my home received a new resident. She is a brittle diabetic (Type 1)and received a diagnosis of Celiac disease two years ago. This is my conundrum-- I can find foods that meet the gluten free diet and I can find foods that meet the diabetic diet... but I can't find foods that are BOTH. What I need is a supplier of sugar free, gluten free food stuffs! Can anyone out there help me?

ShadowedSensei

[Skylark]

One of our moderators is a Type 1 diabetic with celiac. If he doesn't find this thread, you might PM him. His username is psawyer.

Remember that vegetables, nuts, beans, cheeses and meats are all naturally gluten-free and suitable for diabetics.

[sb2178]

Small amounts of fruits and whole grains like kasha, quinoa, and millet are also acceptable when eaten with fat and protein. Tofu, eggs and dairy are also options. If you're on a budget, seeds like sunflower seeds are generally cheaper than nuts. There are a few cookbooks that address the issues if you hav eto budget to get one or even just request it from a local library.

Substitutes like sandwich bread are probably not going to be a great way to go.

[psawyer]

As Skylark mentioned, I am a type 1 who also has celiac disease. The two autoimmune conditions correlate, although we don't understand why. If you have either one, you are more likely to have the other. Type 1 diabetes is pretty easy to diagnose, and it has been suggested that all type 1 diabetics should be automatically screened for celiac.

Both require diet restrictions, but you must understand this: In the event of a conflict, the celiac rules must prevail over the diabetic rules. A bit of extra sugar will be gone within a few hours. The intestinal damage from some gluten can last for several WEEKS.

Many foods suitable for a diabetic diet are naturally gluten-free. Meats and vegetables are gluten-free, unless gluten is added in the preparation. If dairy is tolerated, milk and cheese are gluten-free. Plain fruit is gluten-free, although quantities have to be monitored due to sugar content.

Most of the high-sugar gluten-free products are substitutes for baked products which would be limited on a diabetic diet in any case.

Much also depends on they types of insulin being used. I use Lantus as my basal insulin, taking one injection each night before bed. My short term insulin is Humalog. It is taken on an as-needed basis, testing before meals and calculating the amount needed for the content of that particular meal. Other insulin types may allow less flexibility.

That is a start. I am sure you will have more questions, which I will be happy to tryu to answer.

Oh, and welcome to our board.

[shadowedsensei]

Thank you so much for your prompt replies! This resident presents a particular challenge because of her history... she has been non compliant on diet since she was diagnosed as a diabetic as a child. This has resulted in severe health issues including the administration of a feeding tube to help regulate her sugar levels during the sleep hours. She was released to our home after a year long hospitalization and the insertion of a feeding tube to help regulate her blood sugar levels. She has developed gastroparesis along with the Celiac disease.

I am in charge of all her dietary requirements in an effort to level out her sugar levels and minimize the damage that has been done to her body. Everything that is prepared for her is done in a sterilized kitchen, using utensils that have never been used to prepare other foods. We have made certain that the feeding supplement that she receives via the tube is gluten free (Glucerna). She gets regular meals during the day along with snacks at night. Everything that has been bought for her is gluten free (I spent hours grocery shopping before she came home.)

Her primary insulin is detemir, a long acting insulin that she receives twice daily, morning and night. She has PRN insulin, Novalog, that is used as needed during the course of a day.

In order to help her remain compliant, I'm trying to find substitutes for her favorite snack foods. (She won't eat fruit or nuts but wants cookies, candies and cakes. And state law is that I have to let her eat them). So I'm trying to find either pre-made items or even mixes that are low sugar or sugar free and still meet the gluten free requirement. Currently if she's given something as simple as one single gluten free cookie, her sugar will skyrocket into the 600 range.

[missy'smom]

Here's a link that might be of interest.

Open Original Shared Link

[psawyer]

If she is still non-compliant with the diabetic diet, I would not hold out much hope of her keeping to the gluten-free diet. Unlike the diabetic diet, where an occasional indulgence can be overlooked, for the gluten-free diet to work, adherence must be complete.

Sigh. You can lead a horse to water..

[Skylark]

Carb-one looks really helpful. I found another place with gluten-free, diabetic mixes.

Open Original Shared Link

You might also use one of the gluten-free baking mixes like Arrowhead or Bob's Red Mill with Splenda, but if she's really brittle I don't know that they would work.

Open Original Shared Link

The Bob's might have a lower carb load because it's garbanzo flour but not everyone likes the flavor.

Open Original Shared Link

Good luck teaching her to stay compliant - I hope you can make a difference for her.

[Jestgar]

I am in charge of all her dietary requirements in an effort to level out her sugar levels and minimize the damage that has been done to her body.

(She won't eat fruit or nuts but wants cookies, candies and cakes. And state law is that I have to let her eat them).

If she requested arsenic laced foods would state law require you to give them to her? At what point is food treated as a medical commodity and not a desired one? If she's been placed in a center to keep her healthy why aren't you allowed to keep her healthy? Sounds like a very screwed up system.

[missy'smom]

You have a right to feel the way you do Jestgar. It is a system with pitfalls. God bless shadowedsensei for caring and trying. I have run into those same pitfalls with a relative in a care facility. They are not getting the medical care they should because apparently they are allowed to cancel appointments and nobody can force them to go.

[shadowedsensei]

Actually Jestgar, you raised an interesting point. IF she were to request such an item that falls under a category known as "self endangerment" and I'm legally bound to refuse to provide such a thing. Law requires me, at that point, to contact the police and Crisis Management to have her evaluated for mental disturbance. So it's a lot easier to handle such a request. When it comes to the "bad" foods that she wants, she has all the rights of anyone else to determine what she wants or doesn't want. Before my facility agreed to try to help her, we approached the CRU (complaint response unit-they handle resident rights and investigate abuse allegations) to find out exactly what we could and couldn't do. Legally we cannot restrict her diet in any fashion (that's abuse) but we can provide her with healthy alternatives to the unhealthy things to encourage her to remain compliant. So when she asks me for a cookie I can give her one that meets her dietary restrictions and everything is good, when she wants spaghetti I can give her gluten free... as long as it's the same food she requested. The only way we could "enforce" her dietary compliance would be if she had a guardian that was responsible for her... then the guardian would make all decisions regarding her food and care. It truly is a screwed up system.

Thanks for the sites, I'll check them out.

[shadowedsensei]

Hey just thought I'd post an update on this resident's progress. We're on week two of her residency and so far-drum roll please- she's stable! This is something that the hospital couldn't accomplish after a year! Her sugars are consistently between 110 and 140 and she's completely compliant on both diets! I also found a website that has "snack" items that she can eat and she loves them. For those of you who are interested check out www.thinkproducts.com it's gluten free and low to no sugar protein bars that really taste great! I just want to say thank you to everyone. Your help has been greatly appreciated!

[missy'smom]

That's wonderful! Bless you for all your efforts for her benefit.

[Skylark]

I just saw this. Thanks for sharing such great news. You're a blessing to your client!