{"id":34404,"date":"2013-01-25T13:18:47","date_gmt":"2013-01-25T18:18:47","guid":{"rendered":"http:\/\/asweetlife.org\/?p=34404"},"modified":"2015-12-27T15:45:34","modified_gmt":"2015-12-27T20:45:34","slug":"gluten-free-youve-got-to-be-kidding","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=34404","title":{"rendered":"Gluten Free?!? You’ve got to be kidding."},"content":{"rendered":"
\n
I think we were still in the hospital when Mark suggested\u00a0 that we try having Bisi go gluten free. Upon Bisi\u2019s diagnosis, he had gone into full research mode, and had found a study of a five year old boy in Denmark with T1D who had gone gluten free after a couple of weeks without needing insulin treatment. He had gone into a \u201choneymoon period\u201d\u2014when your pancreas starts working again after diagnosis, after the insulin injections have given the sputtering organ a chance to rest. At the time of\u00a0the study<\/a>, this boy had been in remission for 20 months, and the researchers hypothesized that going gluten free had increased the length of his remission. \u00a0We were told in the hospital that a honeymoon period can last weeks, months, even a year, before its inevitable end. So twenty months is pretty unusual.<\/div>\n
\u00a0<\/div>\n
Mark and I got into a bit of a\u2026 debate about whether Bisi should go gluten-free. I pointed out that Bisi wasn\u2019t even in a honeymoon period, and that the story of one boy in Denmark wasn\u2019t enough reason to make her diet even more restricted than it already was. Also, all of our lives were already going through such huge changes. We hadn\u2019t even perfected the basics of how to carb count or cook for our newly diabetic daughter. How could we pile something as complicated as going gluten-free on top of it? Realistically, how could\u00a0I<\/strong>\u00a0take on the gluten-free cooking\u2014since I\u2019m the one who does 98% of it.<\/div>\n
\u00a0<\/div>\n
Mark did some more research, but the picture didn\u2019t become much clearer. There is no clear link between gluten and diabetes, but there are some intriguing hints. Ten percent of people with T1D also have celiac disease\u2014an intolerance to the gluten in wheat (Bisi tested negative for celiac). In 2009, an\u00a0article in\u00a0Diabetes Forecast<\/em>\u00a0magazine<\/a>\u00a0reported on a Canadian study that indicated that \u201cwheat can cause problems other than celiac in people with type 1 diabetes\u201d:\u00a0\u201cCanadian researchers who studied 42 people with type 1 found that nearly half had an abnormal immune response to wheat proteins, while none of the 22 participants without diabetes had such a reaction. When the researchers looked for a genetic cause of the immune cell overreaction, they found that it was linked to a gene associated with type 1 diabetes\u2014but not related to a gene associated with celiac disease. According to the study\u2019s authors, people with certain genes may be more likely to have an exaggerated immune reaction to foods like wheat, and this may spur other immune problems, like diabetes.\u201d\u00a0<\/div>\n
\u00a0<\/div>\n
Another\u00a0study from 2009<\/a>, published in the magazine\u00a0Diabetes<\/em>, found that \u201cMounting evidence suggests that the gut immune system is involved in the development of autoimmune diabetes. An inflammatory state has been demonstrated to be present in the structurally normal intestine of patients with type 1 diabetes, and the abnormal intestinal permeability that has been found in these patients could represent a contributing factor.\u201d<\/div>\n
\u00a0<\/div>\n
Essentially, the thinking is that people with type 1 diabetes have different intestinal flora than those without, and that their guts are more permeable. (People with other conditions including colic and autism have been found to have different intestinal flora too.) And Mark\u2019s thinking, drawing from these two studies (again, some research backs him up on this, and some doesn\u2019t), is that gluten is part of what has damaged Bisi\u2019s gut, or microbiome, and that perhaps the increased permeability has affected her\u00a0absorption of sugars and overtaxed her pancreas.\u00a0Don\u2019t worry, you\u2019ll be hearing more about the microbiome later\u2014including our search for the best probiotic to inject some \u201cgood\u201d bacteria back into Bisi.<\/div>\n
\u00a0<\/div>\n
So, after talking all this over, Mark and I decided that we would try Bisi on the gluten-free diet (Mark has gone gluten free in solidarity, and because he has psoriasis, an autoimmune disease associated with diabetes and also with differences in the microbiome). We would hope that Bisi would enter a honeymoon period, where her pancreas would start to produce some insulin again. And if she did, we would hope that we could extend her honeymoon.<\/div>\n
\u00a0<\/div>\n
I am still torn about this decision. It has definitely made things harder and more restricted for Bisi; there are so many things we tell her she can\u2019t have\u2014bagels, buttered pasta, pizza. And it sets her apart even more from her friends, when they\u2019re having pizza and cake at a party, and Bisi is eating her special meal of meatballs and a fruit popsicle. Also, we can\u2019t promise her that this is going to make an appreciable difference for her\u2014it\u2019s based on guesswork, not strong evidence. And yet, Bisi really shouldn\u2019t be eating these carby things anyway (all things that she craved before diagnosis; we wonder whether her intense desire for carbs was part of her prediabetes), so going gluten free is an easy way of steering her toward low-carb meals. Also, as Mark argued to me, what if research tells us ten years from now that if you go gluten free when first diagnosed, you can preserve some pancreatic function? We want to make sure that we\u2019ve done everything we can do, and we don\u2019t assume that conventional doctors are looking into or thinking about this approach. Like all parents of a child with a disease,\u00a0we are wishing for a miracle. More realistically, we are\u00a0 hoping that restoring the health of her gut may help with the management of T1D.<\/div>\n
\u00a0<\/div>\n
I have found the diet easier than I thought it would be\u2014though on occasions\u2014like when Bisi is crying because she can\u2019t have the mac and cheese she really wants\u2014it\u2019s been very hard. In general, my strategy has been to avoid bready things in general\u2014ie, we haven\u2019t replaced the bagels with gluten-free bagels (a medium bagel has more than 50 carbs), we\u2019ve replaced them with rice cakes, which are only 7 carbs each. But I\u2019ve also come up with some gluten-free and low carb alternatives so that when all of Bisi\u2019s friends are having brownies or cookies or muffins, she can have some too. Do we know that the gluten-free diet is making any difference whatsoever? No. Do I worry that Bisi will resent our putting yet another restriction on her–and this one by choice? Yes, all the time. But right now, given what we know, it feels like the right thing to be doing.<\/div>\n
\u00a0<\/div>\n
\u00a0<\/div>\n
\u00a0Low carb blueberry muffins<\/a><\/div>\n
\u00a0<\/div>\n
I have adapted some muffins from the web site Diabetes Daily. The blueberry ones are about 12 carbs per muffin, but I\u2019ve also tried this recipe with apples and (unsweetened) pumpkin puree. Bisi loves these for snack; and they\u2019ve been a hit with others as well\u2014ie, not only with those who are forced to eat them.<\/div>\n
\u00a0<\/div>\n
1\/2 cup plain yogurt<\/div>\n
1\/3 cup coconut oil<\/div>\n
2 eggs<\/div>\n
1 tsp vanilla<\/div>\n
1\/3 cup coconut nectar or coconut sugar (available at Whole Foods)<\/div>\n
2 cups almond flour (also available at Whole Foods, or through Bob\u2019s Red Mill)<\/div>\n
pinch of salt<\/div>\n
1 tsp baking soda<\/div>\n
1\/4 tsp cinnamon<\/div>\n
5 ounces blueberries, fresh or frozen<\/div>\n
\u00a0<\/div>\n
\u00a0<\/div>\n
Preheat oven to 310 degrees F.<\/div>\n
If using fresh berries, rinse well and remove any stems or debris.<\/div>\n
In a bowl, mix yogurt, egg, coconut nectar and vanilla together.<\/div>\n
Add coconut oil and blend. (Note: I\u2019ve found that I have to melt the coconut oil in the microwave first.)<\/div>\n
Add dry ingredients to wet, and blend well, add blueberries last.<\/div>\n
Prepare a cupcake\/muffin tin with cupcake liners or use silicone cupcake baker.<\/div>\n
Spoon batter about 3\/4 full.<\/div>\n
Bake for about 20 minutes, or until the center is firm to touch.<\/div>\n
\u00a0<\/div>\n
Yield: 12 small muffins<\/div>\n
\u00a0<\/div>\n<\/div>\n
\u00a0<\/div>\n","protected":false},"excerpt":{"rendered":"

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