Diabetes and Gluten Sensitivity

Posted on January 3, 2011

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Many People with Type 1 Diabetes Have Celiac Disease

About 1 in 20 people with type 1 diabetes has celiac disease. Even in the general population, including people with type 2 diabetes, the rate could be as high as 1 in 250.

Celiac Disease is an autoimmune disorder of the digestive system triggered by an inability to properly digest gluten, a type of protein found in wheat, rye, barley, and other grains. Celiac Disease is one of many forms of gluten sensitivity.

Symptoms of Celiac Disease

The damage from celiac disease takes place over time. The primary symptom of untreated celiac disease is severe damage to the lining of the intestines.

The autoimmune response to gluten sensitivity may lead to chronic inflammation and physical injury to any part of the body, not just the digestive tract. Celiac disease is now clearly linked to epilepsy. Other symptoms of celiac disease may include:

  • Weight loss
  • Bloating
  • Fatigue
  • Skin rash
  • Seizures
  • Development of other autoimmune disorders including diabetes or thyroid disease

The injury from the disease may also lead to poor absorption of many nutrients, impaired growth, and a wide variety of neurological, and psychiatric symptoms.

Many with Celiac Disease Have No Symptoms

When evaluated for celiac disease, many patients show no obvious symptoms. The damage from gluten sensitivity takes place over time and may be avoided with early diagnosis and treatment with a gluten free diet. When tested, physical damage from gluten sensitivity may be present even when there are no symptoms.

Celiac Disease in Children with Type 1 Diabetes

A study reported in The Boston Globe last December indicates that celiac disease and type 1 diabetes may share a common genetic link.Researchers found two type of mutations common to diabetes that might also increase the risks of developing celiac disease.

In an article in ‘Clinical Diabetes,’ physicians Fasy an Umpierrez write, “Evidence of celiac disease is present in a high percentage of children at the time of diagnosis with type 1 diabetes, and these individuals typically develop celiac disease within 4 years of their diabetes diagnosis.”

They further note that, ” 16% have been shown to have positive antibodies, and of these, 6.2% had definitive changes consistent for celiac disease despite being asymptomatic.”

Gluten Free Diet and Type 1 Diabetes in Children

A Danish study reported by Hansen and colleagues placed children identified with type 1 diabetes and celiac disease on a gluten free diet. The researchers followed the children for two years. Children on the diet improved in weight and growth.

The authors of this research note, “This population-based study showed the highest reported prevalence of celiac disease and type 1 diabetes in Europe. Patients with celiac disease showed clinical improvements with a gluten free diet. We recommend screening for celiac disease in all children with type 1 diabetes.”

Long Term Benefits of the Gluten Free Diet

Even when no symptoms are clear, a gluten free diet is likely to benefit adults and children with type 1 diabetes who test positive for celiac disease. In patients with the disorder, Fasy and Umpierrez write that the gluten free diet reduces the possibility of developing small bowel lymphoma and deficiencies of iron, vitamin B12, zinc, calcium, magnesium and fat soluble vitamins.

Early recognition and treatment of celiac disease can often reverse damage to the lining of the digestive tract and improve other symptoms of gluten sensitivity. When patients with type 1 diabetes show symptoms of developing celiac disease, The American Diabetes Association urges physicians to evaluate patients with type 1 diabetes for celiac disease if they show signs of developing this disorder.

Sources:

Boston.com; Juvenile Diabetes, Celiac Disease Linked: Findings may Lead to new Treatments; Reuters, Dec 11, 2008

Fasy EA, MD, Umpierrez G, MD; Celiac Disease: An Important Comorbidity Associated With Type 1 Diabetes; Clinical Diabetes 26:; 85-87, 2008

Hansen D MD, PHD1, et al; Clinical Benefit of a Gluten-Free Diet in Type 1 Diabetic Children With Screening-Detected Celiac Disease; Diabetes Care 29:2452-2456, 2006

Resources:

Juvenile Diabetes Research Foundation International

 

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