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  • Scott Adams
    Scott Adams

    Celiac Disease 20 Times More Likely for Those with Type 1 Diabetes

    Pediatrics 2002;109:833-838.

    Celiac.com 06/06/2002 - The results of a study conducted by Dr. Graziano Barera and colleagues from the Scientific Institute H San Raffaele, Milan, Italy and published in the May issue of Pediatrics indicate that those with type 1 diabetes are 20 times more likely to also have celiac disease. The researchers collected data on 274 consecutive newly diagnosed type 1 diabetes patients with a mean age of 8.28 years. These patients were studied for the following 6 years. At the time of their diagnosis 10 of them (3.6%) already had celiac disease, and over the next 4 years an additional 12 children tested positive for antiendomysial antibodies, and 7 underwent biopsies and were confirmed to have celiac disease. The overall prevalence of biopsy confirmed celiac disease in the group was 6.2%, and most of the cases were asymptomatic and the children showed no obvious signs of the disease. The researchers conclude that greater than 10% of children with newly-diagnosed type 1 diabetes had developed serological markers for celiac disease within the first 6 years of diagnosis, and they recommend that children in this category be screened annually for celiac disease for several years following their type 1 diabetes diagnosis.


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  • About Me

    In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

  • Related Articles

    Scott Adams
    Diabetes Care 2004;27:1294-1298.
    Celiac.com 11/29/2004 - In an effort to determine the prevalence of biopsy-confirmed celiac disease in Italian children and adolescents with type 1 diabetes, and to determine whether age at onset of diabetes is independently associated with the diagnosis of celiac disease, Dr. Franco Cerutti and colleagues at the Universita di Torino, Italy looked at 4,322 children and adolescents (4-11 years old) who had type 1 diabetes. Yearly celiac disease screening was performed on them by using IgA/IgG anti-gliadin and IgA anti-endomysium antibodies, and those with positive antibody results were given a biopsy for confirmation. Out of 4,322 children screened 292 or 6.8% had celiac disease. In 89% of cases diabetes was diagnosed before celiac disease. Using logistic regression analyses the researchers determined that those diagnosed with diabetes at a younger age, those who are female, and those with a thyroid disorder are independently associated with the risk of having both diabetes and celiac disease.
    The researchers conclude: "We have provided evidence that 1) the prevalence of biopsy-confirmed celiac disease in children and adolescents with type 1 diabetes is high (6.8%); 2) the risk of having both diseases is threefold higher in children diagnosed with type 1 diabetes at age 9 years; and 3) girls have a higher risk of having both diseases than boys."

    Dr. Murali Jatla
    Celiac.com 11/06/2007 - This study investigated the effect of screening detected celiac disease in type I diabetic children in a multi-center case-control fashion.  The research team consisted of B Rami, Z Sumni, E Schober et al from Austria, Czech Republic, and Slovenia, among other European countries.
    The team compared 98 diabetics with silent celiac disease to 196 control diabetics without celiac matched for age, sex, diabetes duration.  Mean age at diabetes diagnosis was 6.5 yrs, celiac diagnosis was 10.0 yrs.  Celiac screening included yearly antibody testing and positive patients underwent biopsy.  Hemoglobin A1c, hypoglycemia, ketoacidosis, insulin dosage, body-mass index, and height did not differ between cases and controls at celiac diagnosis or after a mean follow-up of 3.3 years.  After diagnosis of celiac disease, weight gain was diminished in boys with celiac disease compared to their controls.
    Although a clear link between type I diabetes and increased risk of celiac disease is established, the benefit of a gluten-free diet is unclear in these children.  This study followed 98 patients with diabetes and silent celiac for a mean of 3.3 years and compared them to 196 controls.  This is the largest, best designed case-control study to date and it did not demonstrate any significant differences between the two groups, except for a decreased Body Mass Index (BMI - though still greater than non-diabetic, control children) in males after diagnosis. 
    What is more intriguing is that at diagnosis, no significant differences in height, BMI, HbA1c, insulin need, or hypoglycemia events were seen, questioning the metabolic significance of silent celiac disease.  In this study, it is difficult to estimate the duration of silent celiac disease prior to diagnosis.  Although, given the fact that these patients were asymptomatic and their mean diabetes duration was 3.6 years, it likely implies that silent celiac disease was present for a few years.
    The data regarding the benefit of a gluten-free diet in screening detected celiac disease in type I diabetic children is scant but is slowly increasing.  Numerous psychological (burden of gluten free diet in addition to diabetic diet), cost (of diet), and ethical issues (potential long-term benefits of gluten-free diet, compliance with diet) exist regarding these children and hopefully this question will be answered soon and with good, convincing data. 
    Journal of Pediatric Gastroenterology and Nutrition, 41:317-321, 2005

    Jefferson Adams
    Celiac.com 01/05/2010 - Researchers have found that celiac disease often precedes Type 1 diabetes in children with both conditions, and that up to 10% of children with Type 1 have clinical celiac disease, according to findings presented at Gastro 2009 in London, UK by T. Hansson of Uppsala University Hospital, Sweden.
    Hansson explained that researchers detected elevated levels of celiac disease-associated antibodies in children with recent onset Type I diabetes.
    “The presence of autoantibodies against tissue transglutaminase (anti-tTG) implies that celiac disease was present already at the time of Type 1 diabetes onset in all children having both diseases,” he said. “Hence, celiac disease may precede and cause Type 1 diabetes in children with both diseases.”
    A team of researchers looked for anti-tTG in blood samples from 169 children with new-onset Type 1 diabetes, 88 siblings of the patients, and 96 age- and gender-matched controls.
    A total of 21 patients with Type 1 diabetes, six siblings, and three controls showed elevated levels of anti-tTG.
    The team confirmed celiac disease via intestinal biopsy in five children before Type 1 diabetes, and 12 children after onset. Interestingly, blood samples from all but one of the 12 showed elevated anti-tTG at time of Type 1 diabetes onset and the remaining child showed elevated levels within 6 months of onset.
    From this, the research team concludes that 10.1% of children with Type 1 diabetes patients showed confirmed celiac disease, compared with 4.5% of siblings, all of whom were asymptomatic, and 2.1% of controls.
    The researchers suggest that a "change in diet in individuals with genetic susceptibility may reduce the risk of developing Type 1 diabetes." They add that “all Type 1 diabetes children and their siblings should be routinely screened for celiac disease-related antibodies.”
    Source: Gastro 2009, UEGW/WCOG; London, UK: 21–25 November



    Jefferson Adams
    Celiac.com 09/19/2012 - Researchers have documented rising rates of celiac disease in patients with type 1 diabetes (T1D). A research team recently tried to assess the effect of celiac disease on growth and glycemic control in patients with T1D, and to determine the effects of a gluten-free diet on these parameters.
    The research team included I. Taler, M. Phillip, Y. Lebenthal, L. de Vries, R. Shamir, and S. Shalitin. They are affiliated with the Department of Pediatrics B, Schneider Children's Medical Center of Israel in Petach Tikva, Israel.
    To do so, they conducted a longitudinal retrospective case-control study, in which they reviewed the medical data on 68 patients with T1D and duodenal-biopsy-confirmed celiac disease. They looked at weight, height, hemoglobin A1c (HbA1c), frequency of diabetic ketoacidosis (DKA), and severe hypoglycemic events before and after diagnosis and treatment of celiac disease.
    They then compared their findings with 131 patients with T1D alone, who were all matched for age, gender, and duration of diabetes.
    In all, 5.5% patients with T1D who attended the center during the study period were diagnosed with celiac disease, while 26% of the patients with celiac disease were symptomatic.
    The data showed no significant differences in glycemic control or frequency of severe hypoglycemia or DKA events between the study group and control subjects.
    Body mass index-standard deviation score (SDS), height-SDS, and HbA1c values were insignificantly higher in the control group than in the study group, and similar in celiac disease patients with good or fair/poor adherence to a gluten-free diet during follow-up.
    Patients with T1D and celiac disease and following a gluten-free diet have growth and metabolic control similar to those with T1D with no celiac disease.
    To determine whether a gluten-free diet is appropriate for asymptomatic celiac patients or only symptomatic patients must be assessed against possible short- and long-term consequences of no intervention, and the decision should be based on more evidence from larger randomized studies.
    Source:
    Pediatr Diabetes. 2012 May 7. doi: 10.1111/j.1399-5448.2012.00878.x.

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    I just read that sulfate might be in pickles I am allergic to sulfate so if this is true that is why I feel itchy after eating them I honestly didn't notice it till my boyfriend said people are saying pickles make them sick  then I felt itchy everywhere even in my mouth I had vlasic pickles the jar said gluten free and my stomach doesn't hurt but I do itch I just ate them also maybe an hour ago 
    I have minimal GI symptoms.  If I go gluten-free, I feel better but when I eat gluten, nothing major to remark of.   I'm the kind of person who likes to do one thing at a time to get clear answers, so will add in the enzymes after the 3 mos gluten-free and bloodwork test.  My chiropractor has that as the next thing to add in, I'm not sure exactly which ones he planned.   The ARMD changes things a bit, because no one's really heard of it starting so young from chronic poor absorption. 
    Well, I would think your GI doc would want you to have been eating gluten before both the blood test and the endoscopy . That said, this is how my experience went down: I had symptoms and was misdiagnosed for years and years. I met a new friend who suggested going gluten free. I did so about a year before changing doctors and getting tested. My GI doc didn’t care that I was gluten free because he didn’t think anyone was completely gluten-free. I tested negative. He had me have the chromosome tes
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