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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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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.

I have been having issues with gluten for quite some time now and decided to go gluten free back in October, I finally got the celiac blood test a couple weeks ago and it came back inconclusive. My doctor referred me to a gastroenterologist who I saw today, she told me I'd have to eat gluten rich foods for 1 month and then have another blood test done....of it comes back negative she said I'd need to eat gluten another few weeks (up to another month) and then do a scope and biopsy....this would be hell on me as I have severe cramping and nausea when I am exposed to gluten. I haven't actually eaten anything that is straight gluten like bread so I'm not sure what would happen. She gave me the option to hold off and continue my diet or go through 2 months of pure gluten exposure (and pain) my question is has anyone been faced with this? Should I just continue with my gluten free diet and assume I have it or is the diagnosis really that important? Doc says based on my symptoms and reactions I more than likely have it.