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What is the Effect of Celiac Disease on Growth and Glycemic Control in Patients with Type 1 Diabetes?

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.

Photo: CC--Jill A. BrownThe 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.

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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.

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We have gone gluten free, our whole house, as of a month ago. It was pretty seamless since I had been gluten-free for 5 months last year. I have found many good recipes, and my picky husband and one of my boys who is also a picky eater, even prefer many gluten-free recipes to the regular ones. My husband did see my point about the size of the gluten protein means nothing. Its a gluten protein period, that's what you are avoiding. It doesn't matter if its hiding in the scratch of your baking sheet and you can't see it. You can't see the wind, but it's still there. I hear you on the anemia. I've been anemic for several years, I just thought it as because I was getting a little older. Has your anemia gone away or do you still have problems with it?

Ennis, it is made out of metal, coated with plastic I think. You have such a hard time, my heart really hurts for you. But you are such a support to those on this board, and a great teacher for those of us who are new.

Thanks everyone! I think its hard for people to fully accept because they cant see the damage it does every time you get glutened. It's invisible. Im glad to know I wasnt being paranoid. I sure was when I was first diagnosed. I laugh at myself now, but its a pretty steep learning curve.

FYI......anxiety is a common symptom with celiac disease and NCGI. It seems to resolve on a gluten-free diet. ?

Yes, I will definitely update you and would love to hear what your experience is. I'm glad I found this forum because you're right--it's nice to not feel so alone. I'm also prone to anxiety--so waiting and worrying is not fun! Cyclinglady, thanks for sharing your experience as well. I do plan to maintain a gluten-free diet for a while at least if the biopsy is negative just to see how I feel.