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Celiac Autoimmunity in Type I Diabetes Mellitus

Celiac.com 02/10/2015 - A number of studies have shown a connection between celiac autoimmunity and type 1 diabetes mellitus (T1DM). Doctors recommend celiac screening for T1DM patients, but screening is not always conducted.

Photo: CC--Heather AitkenMeanwhile, reports about the impact of celiac autoimmunity in T1DM have been varied. A team of researchers recently set out to determine rates of celiac autoimmunity in patients with T1DM, and to study the impact of celiac autoimmunity on nutritional parameters, glycaemic control, endocrine axes and bone health.

The research team included A.S. Joshi, P.K. Varthakavi, N.M. Bhagwat, M.D. Chadha, AND S.S. Mittal. They are variously associated with the Department of Endocrinology of Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai Central in Maharashtra, India.

For their study, the team conducted celiac autoimmunity screens on eighty-six consecutive patients with T1DM using immunoglobulin A (IgA) tissue transglutaminase as a marker (TTG; IgG anti-gliadin in IgA-deficient case). They compared CA positive (CA+) T1DM cases with age-matched and sex-matched CA negative (CA-) T1DM cases for anthropometry, glycaemic control (as assessed by glycated haemoglobin (HbA1c) and hypoglycaemic/hyperglycaemic episodes), endocrine (thyroid function, cortisol, growth hormone (GH) axis, gonadal axes), haematological (haemoglobin, iron profile and vitamin B12 status) and calcium metabolism parameters and bone densitometry (by dual-energy X-ray absorptiometry (DXA)).

Consenting patients with celiac autoimmunity also underwent upper gastrointestinal (GI) endoscopy with duodenal biopsy.

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Results showed that 11 of the 86 patients, about 12.75%, screened positive for celiac autoimmunity. Of those, seven patients underwent duodenal biopsies which suggested two cases of Marsh grade III, three cases of Marsh grade II and two cases of Marsh grade I celiac disease.

In terms of anthropometry, CA+ T1DM patients were comparable with CA- T1DM patients. Overall, CA+ patients had higher HbA1c (10.7±1.8 vs. 8.4±1.0 (93±19 vs. 68±11 mmol/mol); p

The incidence of fractures in the past 3 years was four CA+ patients, and one CA- patient (p<0.05).

There is an important autoimmune connection between celiac disease and T1DM. For people with T1DM, celiac disease adversely affects stature, bone health, glycaemic control and iron and B12 levels.

The study team recommends that IgA sufficiency be established before using an IgA-based screening test for celiac autoimmunity.

Source:

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2 Responses:

 
Rebecca
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said this on
16 Feb 2015 2:21:37 PM PDT
My son was diagnosed with type 1 at 12 months old. At 12 years old after years of trying to figure out why he stopped growing on the growth chart, he was finally diagnosed with celiac. He had complete atrophy of the villi. The first year gluten free he grew 6 inches and gained 20 pounds. The good news is he's a college athlete today and as healthy and happy as ever. These diagnosiss don't mean the end of a great quality of life

 
Robin
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said this on
17 Feb 2015 6:42:25 AM PDT
You may add me to the list of being diabetic 45 years and 1 1/2 years with celiac disease. Thank you for posting this connection of the 2 autoimmune disease, so maybe doctors will start testing for celiac when they see the person with diabetes having gut issues instead of treating for spastic colon and irritable bowel with medicine for years. THANK YOU




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