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Long-term Celiac Disease Increases Death Rates in People with Type 1 Diabetes

Celiac.com 06/26/2013 - Do people with type 1 diabetes (T1D) and celiac disease die younger than people with T1D who do not have celiac disease? Do celiac patients without T1D live longer than those with T1D? Currently, not much is known about how celiac disease might influence mortality rates in people with T1D.

Photo: CC--SkenderA team of researchers recently set out to examine rates of death in patients with both T1D and celiac disease. The researchers include K. Mollazadegan, D.S. Sanders, J. Ludvigsson, and J.F. Ludvigsson. The are variously affiliated with the Clinical Epidemiology Unit of the Department of Medicine, Solna, Karolinska Institutet, and with St. Erik Eye Hospital, Karolinska Institutet in Stockholm, Sweden.

The research team set out to examine mortality in patients with both type 1 diabetes (T1D) and celiac disease. For their study, the team used biopsy reports to identify all people diagnosed with celiac disease between 1969 and 2008, within all 28 pathology departments in Sweden. They defined T1D as a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009 in individuals aged ≤30 years.

Their follow-up showed 960 patients with both T1D and celiac disease. For each individual with T1D and celiac disease, they selected up to five subjects with T1D alone (no celiac disease) as a reference group of 4608 individuals. They then matched all reference individuals for sex, age and calendar period of diagnosis.

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The team used stratified Cox regression analysis with celiac disease as a time-dependent covariate to estimate the risk of death in patients with both T1D and celiac disease compared to those with T1D alone.

The results showed that celiac disease was not a risk factor for death in patients with T1D in the first 5 years after celiac disease diagnosis [hazard ratio (hazard ratio) 0.87, 95% confidence interval (CI) 0.43-1.73].

However, with the passage of time, that reality changed, and mortality risk rose in direct relation to follow-up time (5 to

In the end, for people with T1D, having a celiac disease diagnosis for at least 15 years was associated with a 2.80 times greater risk of death (95% CI 1.28-6.12).

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So, here goes...my visit with the GI specialist is on Monday. I had tested positive for the IGG antibody and all other bloodwork was negative. I had numerous trips to emerg with stomach pain, lower back pain, tingly tummy, and diarrhea with alternating "c" (I had the word constipation). One diagnosis of diverticulitis, another of IBS, and symptoms continued to get worse....Low B12 for 7 years and abnormal liver (something like hepatocellular disease with cirrhosis). I only have a glass of wine on the weekends...I had been diagnosed in my early 30s with IBS and imodium helped. I also had a rash on my elbows and back and that is when my new GP said maybe it is celiac and she sent me for bloodwork and 3 months later finally get to see the GI specialist. I went gluten free and at first it was hard. It is much easier now...I think at time I give myself contamination because I get some bouts of pain on occasion and I take buscopan and immodium and then I am fine....I am 100% convinced I have celiac but I guess I really do not understand how the rest of the panel would be negative... The rash, the GI symptoms, the B12, and the liver issue all paint a compelling picture...I never thought I would say this but I hope it is truly diagnosed because then I can move forward with a plan. I am down 22 pounds and back at the gym very hard and feeling almost normal for the first time in many years....I also find is so strange that my "gluten" attack usuallys starts with a pins and needs tingly sensation in my back and tummy...I have written a full history and have copies of all my test results so the GI specialist takes me seriously...I read his reviews and they are not good....I understand I will have to do gluten before the endoscopy but that fine...just looking forward to this being partly over...Have a great day!

http://www.cureceliacdisease.org/faqs/ You can also find lots of information on celiac at the University of Chicago celiac site. One test they suggest is the anti EMA antibodies. I don't see that one listed in her results. Probably because it is more expensive to do. So they may have skipped it. The other test they usually do is the total serum IGA levels, which is used to prove that the person's immune system actually makes IgA antibodies. Some people don't make IgA antibodies, so the IgA tests are useless in them. It looks to me like she makes IgA though, if this is the serum IgA result. IgA 133 mg/dl Reference range 33-200 There are also gene tests they can do. The genes indicate the possibility of developing celiac disease, not the automatic presence of celiac disease. About 30% of people in the USA have one of the genes for celiac disease, but only about 1% develop celiac disease. Some of the celiac genes are associated with other autoimmune conditions besides celiac disease. So there are lists of AI associated conditions with celiac disease. Sometimes called related conditions. http://www.drschaer-institute.com/us/celiac-disease/associated-conditions-1051.html

Blood was drawn this afternoon... they said I could get results tomorrow or even the next day! I also have a GI appt scheduled for June 9th. I am so glad I will have at least some kind of answer pretty soon. I'll let you all know. Thanks again for being so helpful!

Thank you so much for those links, I will check into it. Her pediatrician told me this afternoon she is wanting to repeat the bloodwork since that one test was elevated. I'm relieved that her pediatrician didn't dismiss it like the other dr in the practice did.

http://www.houstonceliacs.org/ https://www.csaceliacs.org/csa_chapter_25.jsp You can check with these groups to see if they recommend any doctors in Houston.