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Gluten-Sensitive Enteropathy in Patients with Insulin-Dependent Diabetes Mellitus

Author: Rensch MJ; Merenich JA; Lieberman M; Long BD; Davis DR; McNally PR.
Address: Fitzsimons Army Medical Center, Aurora, Colorado, USA.
Source: Ann Intern Med, 124: 6, 1996 Mar 15, 564-7

OBJECTIVE: To determine the prevalence of celiac disease in a cohort of patients with insulin-dependent diabetes mellitus and to describe the clinical characteristics of patients with coexistent disease.

DESIGN: Prospective cohort study.

SETTING: U.S. Army medical center.

PATIENTS: 47 patients with insulin-dependent diabetes mellitus.

MEASUREMENTS: Antiendomysial antibody testing was used to screen for celiac disease. The diagnosis of celiac disease required histologic evidence of villous atrophy and

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glands of the intestinal mucous membrane, also known as the crypts of Lieberkühn, attached to the villi of the intestines.'); return false">crypt hyperplasia and a positive antiendomysial antibody test result. In patients identified as having coexistent disease, complete blood counts, multiphasic biochemical testing, D-xylose absorption testing, and bone mineral density estimates were done.

RESULTS: 3 of 47 patients with insulin-dependent diabetes mellitus (6.4%; 95% CI, 1.4% to 17.5%) had positive antiendomysial antibody test results and small-bowel biopsy specimens consistent with celiac disease. The 95% CI lies entirely above the estimated prevalence of celiac disease expected in the general U.S. population, which ranges from 0.02% to 0.1%. Mean bone mineral densities were 0.8 and 1.1 SD below age-, ethnicity-, and sex-matched controls in each of the 2 antiendomysial antibody-positive patients tested. Small bowel absorption was abnormal in 1 of the 2 patients tested by D-xylose. Anemia and hypoalbuminemia were not detected in any of the patients with coexistent disease. Only 1 of the 3 patients had symptoms of diarrhea. All patients were at or above their ideal body weights.

CONCLUSIONS: Celiac disease appears to be more common among patients with insulin-dependent diabetes mellitus than in the general U.S. population (p less than 0.001). Two of the three patients with coexistent disease in this study had sub-clinical or latent celiac disease.

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Scott
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30 Nov 2012 2:10:43 PM PST
Test Celiac is a very lonely, isolating disease. You turn down food at social gatherings, because when in doubt go without, and you suddenly become the obsessive freak about her food. It's up for the judges to prove plagiarism




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