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Risk Markers for Insulin-Dependent Diabetes Mellitus and Duration of Exposure to Gluten in Celiac Patients

Celiac.com 10/28/2004 - The following study demonstrates a connection between the length of time a celiac is exposed to gluten and the prevalence of anti-islet cell antibodies. This study supports many others that have shown that celiac patients are at high risk of developing insulin-dependent diabetes mellitus, which is a condition that has a long pre-diabetic period. It would be interesting to conduct a similar study on non-celiacs to determine if gluten has the same effect, which, if demonstrated, would mean that gluten has toxic, disease-causing properties in other people in addition to those with celiac disease.

Rev Med Chil. 2004 Aug;132(8):979-84.

BACKGROUND: Celiac patients are at high risk of developing insulin-dependent diabetes mellitus, a condition that has a long pre-diabetic period. During this lapse, anti-islet cell antibodies serve as markers for future disease. This may be related with the duration of the exposure to gluten. AIM: To test the hypothesis that long term adherence to a gluten free diet decreases the frequency of risk markers for insulin dependent diabetes mellitus during adolescence and early adulthood.

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PATIENTS AND METHODS: 158 celiac patients were classified as: G1, (n=30 patients) studied at the time of diagnosis; G2 (n=97 patients) exposed to gluten as a result of non compliance with the gluten free diet and, G3 (n=31 patients) who had maintained a long term, strict gluten free diet. Isotype IgG anti-islet cell antibodies were detected by indirect immunofluorescence using monkey pancreas, results were reported in Juvenile Diabetes Foundation (JDF) units.

RESULTS: Celiac patients exposed to a gluten containing diet had a significantly higher prevalence of anti-islet cell antibodies than those who had been exposed only briefly (p < 0.017). In addition, a significantly higher prevalence of anti-islet cell antibodies was observed in those patients whose exposure to gluten was longer than 5 years than in those whose exposure was shorter (p < 0.02).

CONCLUSIONS: Celiac patients long exposed to gluten have a significantly higher prevalence of anti-islet cell antibodies than those exposed for a short period. This fact supports the hypothesis that the development of these antibodies is associated with the length of the exposure to gluten.

Verbeke S, Cruchet S, Gotteland M, Rios G, Hunter B, Chavez E, Brunser O, Araya M.
Unidad de Gastroenterologia, Division de Nutricion Humana, Instituto de Nutricion y Tecnologia de los Alimentos, Universidad de Chile, Macul 5540, Santiago, Chile.

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