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Does Celiac Disease Protect Against Aspects of Type 1 Diabetes Mellitus?


Celiac.com 07/22/2011 - Many reports indicate a hypercoagulative state in diabetes mellitus as result of endothelial damage. Numerous researchers have reported a strong association between type 1 diabetes mellitus (DM1) and celiac disease.

Clinical data indicate that vascular dysfunction can result from a cascade of biochemical events triggered by a metabolic malfunction. The net result changes the cells that line the interior surface of the blood vessels; from a surface called a thrombo-resistant surface to one called a thrombo-genic surface.

A research team recently set out to determine whether celiac disease in a group of DM1 patients is connected with a different expression of certain hemostatic factors, and with a different manifestation and/or progression of microvascular complications of DM1, as compared to patients with diabetes alone.

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For the study, the team enrolled ninety-four adult patients with DM1, who they then screened for celiac disease. They found anti-endomysial antibodies (EMA) in 13 of 94 DM1 patients (13.8%). The team then confirmed celiac disease diagnosis by histology and organ culture.

The mean age and duration of DM1 of patients also affected by celiac disease were similar to those patients with diabetes alone, but the groups showed very different parameters for metabolic control and hemo-coagulation. In DM1 patients with celiac disease those parameters include:

  • Significantly lower concentrations of glycosylated hemoglobin (HbA1c) (P.05), cholesterol (P.001), triglycerides (P.001), factor VII antigen (FVII:ag) (P.005), factor VII coagulant activity (FVII:c) (P.05), and prothrombin degradation fragments (F1+2) (P.001).
  • Higher values of activated C protein (APC) (.001).
DM1 patients with celiac disease showed no retinal abnormalities and no signs of renal damage.

The results suggest a potential protective role of celiac disease in the pro-thrombotic state of DM1.

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6 Responses:

 
Nicole
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said this on
25 Jul 2011 5:56:16 AM PDT
Interesting, thanks. I sure would love to know of any studies that look at the case where a celiac diagnosis is made prior to a Type 1 diabetes diagnosis (typically it's the T1 first, then celiac, as I'm sure you know).

 
Cathy

said this on
21 Mar 2013 3:07:22 PM PDT
I have celiac disease and dermatitis herpetiformis. My brother also has celiac disease - he was diagnosed about 3 years ago and was just recently diagnosed with Type 1 diabetes. I am now what they are calling borderline diabetic.

 
raiskin
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said this on
25 Jul 2011 11:51:06 AM PDT
This is fascinating. My daughter has both celiac and type 1 diabetes. The combination makes social life difficult (as well as physical health). It is really nice to read something that suggests something positive about celiac other than the many dire possibilities and connections with other diseases!

Thank you for all the work you do! I refer to your safe and unsafe list all the time.

 
Valeria
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said this on
30 Sep 2011 5:01:22 AM PDT
Thank you for the good news. I am type 1 diabetic diagnosed 40 years prior to coeliac. I showed a mild retina alteration about 30 years ago. ever since then i have not developed any further diabetes complication to the amazement of my diabetes doctor.

 
Holly
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said this on
11 Jan 2012 9:33:24 PM PDT
This is a really interesting article. I am both a type one diabetic and have celiac disease. I got type 1 when I was five years old and now am 21. I am hanging on by a thread with it because being on an insulin pump tends to be a real struggle for me because of skin irritation and the sites giving me issues but I cope with it. When I was a sophomore in high school I was tested for celiac disease because my endocrinologist had a strong feeling that I was carrying the symptoms for it. She sent me to a doctor she recommended and turned out I was borderline celiac and still am. I can't say I follow the celiac diet to a T because it is hard to handle and keep in line but I try my best and try to cut out gluten in my diet as often and much as possible. I face the fact that nothing is perfect and celiac is a tough thing to deal with. A combination of both these diseases really hit hard and already having diabetes since 11 years prior really scared me because many of the alternatives include rice and high starch and carbohydrate food products and being on an insulin pump, your goal is to eat healthy and try to eliminate those types of things as much as possible to control sugar as well as keep your insulin intake down. I am personally turned off by rice and the thoughts of eating it just scare me because I always feel awful afterwards. I choose to not eat it even though I am celiac dependent. All I can say to anyone who is in this type of situation is to take everything day by day, you can definitely take it on if you put your mind to it. It is hard but everything in life is and this is just another step you have to take to make it through your life and to live a healthy and happily as well. Good luck to all.

 
Haley
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said this on
05 Jul 2012 5:57:53 AM PDT
Thank you for this article and also thanks to the comment by Holly. I was diagnosed with Type 1 at age 3 and am now 31. I was on in insulin pump from 2004 until this past January, when my pump broke and I decided to try injections for a time. I also have problems with irritation of the skin and wanted to see if using injections would work. I have now been on injections for 5 months and my HbA1C has run about the same as when on the pump. You might give the pump a rest for a few months and then try again. Sometimes I think that we need a break.

Also, I started having stomach issues last year and was finally diagnosed with gluten sensitivity, along with other sensitivities to rice, pork, chicken, beef, soy, corn, pumpkin and coconut. What am I supposed to eat, especially when this culture lives off of rice and chicken?

So, Holly, I understand your dilemmna. Because I live in Thailand, I can't test for celiac, but I could do a test by Enterolab that tested for food sensitivities. You might also check out MRT (Mediator Release Test). If rice irritates your stomach you might also be sensitive to that. I am. When I return to the states this year I will test for celiac disease and other food sensitivities.

Blessings and yes, I agree that if you put your mind to it, you can have a blessed life. It is challenging, no doubt.




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Only GIs can order a complete celiac panel at Kaiser. Your results look negative, but those are just "screening" results. You are not IgA deficient (used only as a control test for celiac disease) so that means the TTG IgA test worked. If you suspect celiac disease, ask for a GI referral. Keep eating gluten!!!! If you go gluten free then all the celiac tests will be invalid. You should rule out other issues like Crohn's, SIBO, etc based on your symptoms and health history. I would ask for a complete celiac panel from the GI. Why? Not all celiacs test positive to the TTG which is a cheaper, but excellent test but does not catch all celiacs like me!!!

Ditto. However, this is what I can never understand about gluten free food. (see the bold bits which I've taken from the article) "We wanted to determine if gluten consumption will affect health in people with no apparent medical reasons to avoid gluten. Gluten-free foods often have less dietary fiber and other micronutrients, making them less nutritious and they also tend to cost more,? I wonder why what so much of what I eat that's gluten free doesn't have added vitamins - we of all people need fortification in our cereals and bread, surely?

Yeah we learned that the hard way. I am inclined to think (as I did initially) that it was JUST the Cheerios but as time is passing and she is not bouncing back I am worried that we need to strip away dairy again for a while.

Oh I have no issue with being dairy free personally but tell that to a 13 year old. We both went gluten-free at the same time and it has been mindlessly easy for me. But I am easy about food and no real food issues. I am far more adaptable. She comes to the table with her own unique set of issues that complicate just easily transitioning to dairy free versions of much loved favorites. To most they are jst that "substitutes" to her they are completely different foods and ones that she has no interest in eating. They don't satisfy her need for XYZ. It is like craving an apple and someone handing you a fish. For her anyway! LOL!

I believe the talk around this forum is that cheerios are not gluten free enough for people with celiac at this time. I don't know if anything has changed on that and when their lawyer calls me I'll quickly delete this. haha