Celiac.com 03/19/2026 - This study explored why two autoimmune diseases that often share genetic risk factors—celiac disease and type one diabetes—do not always develop together. Although both conditions are strongly linked to the same immune-related genes, many people develop only one of them. The researchers set out to understand whether subtle genetic differences inside a well-known immune gene region could help explain this split in disease outcomes

Background: Shared Genetics, Different Outcomes

Celiac disease and type one diabetes are both autoimmune conditions, meaning the immune system mistakenly attacks the body’s own tissues. In celiac disease, the immune system damages the lining of the small intestine when gluten is eaten. In type one diabetes, immune cells destroy insulin-producing cells in the pancreas.

Both diseases are strongly linked to the same immune gene region on chromosome six. This region controls how the immune system recognizes proteins. Many people who carry these high-risk genes never develop either disease, while others develop only one. This mismatch has long puzzled researchers and clinicians.

The Focus on a Small but Important Genetic Region

The researchers focused on a tiny section of a gene involved in immune signaling. Although this gene was once considered stable and unimportant for disease risk, earlier work suggested that small variations in this region could significantly influence the likelihood of developing type one diabetes.

In this study, scientists examined three closely grouped genetic markers inherited together. These markers form distinct patterns that can subtly change how immune-related genes behave. The research team analyzed how these patterns affected disease development over time.

Following Children at Risk from Birth

The study followed thousands of children enrolled at birth because they carried genetic risk factors for autoimmune disease. These children were regularly monitored for immune activity, including early immune markers that appear before symptoms of disease.

Over more than a decade of follow-up, researchers tracked which children developed immune markers linked to type one diabetes, which developed markers linked to celiac disease, and which eventually received a clinical diagnosis.

A Protective Effect for Type One Diabetes

One of the most striking findings was that a specific genetic pattern significantly reduced the risk of developing type one diabetes. Children carrying this pattern were less likely to develop early immune markers against insulin and less likely to progress to full disease.

This protective effect was strongest in children who otherwise carried the highest known genetic risk for type one diabetes. The results confirmed earlier findings and demonstrated that even within high-risk groups, genetic fine details matter.

The Unexpected Increase in Celiac Disease Risk

While this genetic pattern appeared protective for type one diabetes, it had the opposite effect for celiac disease. Children carrying the same pattern were more likely to develop immune reactions against gluten and more likely to receive a celiac disease diagnosis.

This opposite influence was unexpected because the two diseases are usually thought to share similar genetic drivers. The finding suggests that certain immune pathways may push the body toward one autoimmune target while pulling it away from another.

Early Immune Signals Reveal Different Disease Paths

The study also examined early immune markers that appear before disease symptoms. For type one diabetes, the protective genetic pattern mainly reduced immune responses directed at insulin, which are often seen early in childhood.

For celiac disease, the same genetic pattern increased the likelihood of developing antibodies linked to intestinal immune damage. These early signals often appear years before symptoms, suggesting that the immune system’s direction may be set very early in life.

Clues from the Complement System

To understand why one genetic pattern could have opposite effects, the researchers examined immune gene activity in blood cells. They found differences in genes involved in the complement system, which plays a role in immune defense and inflammation.

Some versions of the genetic pattern were associated with reduced activity or missing copies of certain complement genes, while others showed increased activity of related genes. These differences may alter how the immune system clears immune complexes or responds to environmental triggers.

Why These Findings Matter

This research highlights how small genetic differences can significantly influence autoimmune disease outcomes. Rather than viewing celiac disease and type one diabetes as nearly identical in genetic risk, the study shows that risk can be redirected in opposite directions by subtle variations.

These findings may help improve risk prediction models. Knowing whether a child with high-risk immune genes is more likely to develop celiac disease rather than type one diabetes could guide monitoring strategies and early interventions.

What This Means for People with Celiac Disease

For individuals and families affected by celiac disease, this study offers important insight. It reinforces that celiac disease is not simply a byproduct of shared autoimmune risk but may involve distinct immune pathways that deserve focused attention.

Understanding these genetic differences could eventually lead to earlier identification of at-risk individuals, better screening strategies, and more personalized approaches to prevention and care. For people living with celiac disease, this research helps explain why the disease can appear independently, even in families where multiple autoimmune risks are present.

Read more at: elifesciences.org

Celiac.com 06/02/2025 - Researchers have known for years that a gluten-free diet can delay or even reduce the risk of type 1 diabetes in a special kind of lab mouse known as the nonobese diabetic mouse. However, the exact reasons why removing gluten helps have remained unclear. Scientists wondered whether gluten might directly change important immune cells that are involved in the development of autoimmune diseases like diabetes. In this study, they decided to carefully examine the immune system of these mice — particularly different types of T cells — to see exactly how a gluten-free diet influences them.

What the Researchers Did

The researchers compared two groups of nonobese diabetic mice. One group ate a standard diet containing gluten, while the other group followed a gluten-free diet. They looked closely at immune cells from two important locations in the body: the spleen and the pancreatic lymph nodes. These areas are critical because they help regulate how the immune system responds to threats — or in the case of autoimmune disease, how it mistakenly attacks the body’s own tissues.

Using advanced techniques that allow scientists to study individual cells and their gene activity, the team analyzed T cells and other immune cells to find any differences between the two groups.

Key Findings

No Major Overhaul of the Immune System

One of the first things the researchers noticed was that the gluten-free diet did not cause dramatic changes to the types or numbers of immune cells. There was no major expansion or disappearance of any one cell type that would explain why a gluten-free diet protects against diabetes. Instead, the changes were much smaller and more spread out across different groups of T cells.

Subtle but Important Shifts

Even though the changes were minor, the gluten-free diet appeared to encourage certain beneficial immune cells. Some of these cells are known to help regulate the immune system and prevent it from attacking healthy tissue. These included:

• Regulatory T cells (Tregs): These cells help keep the immune system from becoming overactive. While the total number of Tregs did not dramatically rise, a special type of Treg with potentially strong protective abilities was slightly more common in mice on a gluten-free diet.
• Gamma delta T cells (γδT cells): This unique type of T cell was found in a form that is believed to be more calming to the immune system in the gluten-free mice. These cells are thought to produce helpful substances that prevent inflammation.
• Natural Killer T cells (NKT cells): In the gluten-free group, these cells shifted toward types that may help regulate the immune system better and suppress autoimmunity, whereas the mice on a standard diet had more aggressive types of NKT cells that might contribute to disease.

Different Gene Activity Patterns

The researchers also found differences in the way genes were switched on or off in the immune cells. In mice on the gluten-free diet, genes involved in promoting healthy immune activation and communication between cells were more active. On the other hand, the mice eating a standard diet showed signs of a more stressed immune system, with higher activity of genes linked to inflammatory responses.

Interestingly, the gluten-free diet seemed to stimulate signals involving key immune growth factors like interleukin 2, interleukin 7, and interleukin 15, all of which play roles in developing a balanced immune system. Meanwhile, the standard diet triggered genes that respond to type I interferons, molecules often associated with the early stages of autoimmune diseases.

What This Means for Diabetes Development

Instead of stopping diabetes by making one big change to the immune system, the gluten-free diet seems to work by gently nudging many small parts of the immune system toward a healthier balance. This "many small changes" approach might be enough to prevent the chain reaction that normally leads to autoimmune diabetes in these mice.

One particularly interesting finding is that a standard diet — not the gluten-free one — was linked to a more immature and inactive immune system. This fits with the "hygiene hypothesis," which suggests that not exposing the immune system to enough challenges early in life could actually make it more prone to developing autoimmune diseases later.

Additionally, the gluten-free diet’s effect on critical immune cells like regulatory T cells, gamma delta T cells, and natural killer T cells highlights the importance of subtle immune system tuning in preventing autoimmune attacks on the body’s own tissues.

Why This Study Matters for People with Celiac Disease

Although this study was done in mice and focused on diabetes, it has meaningful insights for people with celiac disease and other autoimmune conditions. Celiac disease is itself an autoimmune disorder where the immune system attacks the small intestine in response to gluten. This research shows that removing gluten from the diet can cause small but important shifts across many parts of the immune system, leading to a more controlled and less aggressive immune response.

For people with celiac disease, this suggests that strict adherence to a gluten-free diet might not only protect the gut but could also help restore better overall immune balance. Additionally, since autoimmune diseases often cluster together (people with celiac disease are at higher risk for diseases like type 1 diabetes and thyroid disease), this study supports the idea that a gluten-free diet could have broader health benefits beyond managing intestinal symptoms.

In conclusion, even small, subtle shifts in the immune system caused by a gluten-free diet might have powerful long-term effects, reducing the risk of autoimmune attacks and promoting healthier immune function. This research offers hope that dietary changes can meaningfully influence autoimmune diseases — not just treating symptoms, but potentially reshaping the immune system itself toward a more balanced state.

Read more at: onlinelibrary.wiley.com

Celiac.com 05/29/2025 - Children with type 1 diabetes (T1D) face a higher risk of developing celiac disease (CD) compared to the general population. Diagnosing celiac disease in these children can be challenging because symptoms are often mild or absent, and standard screening tests may not always provide clear answers. A recent study from Switzerland aimed to determine the best way to identify which children with T1D should undergo further testing—such as an intestinal biopsy—to confirm celiac disease. The research focused on antibody levels in the blood, which can signal the presence of celiac disease, and explored whether combining different antibody tests could improve accuracy.

Why This Study Matters

Celiac disease is an autoimmune disorder where the ingestion of gluten damages the small intestine. Since both T1D and CD involve immune system dysfunction, children with diabetes are more likely to develop celiac disease. However, diagnosing CD in these children is complicated because:

• Many have no obvious symptoms.
• Blood test results can fluctuate over time.
• There is no universally agreed-upon threshold for when a biopsy (the gold standard for CD diagnosis) should be performed.

This study sought to clarify when doctors should recommend a biopsy by analyzing antibody levels in children with T1D over time.

How the Study Was Conducted

Researchers examined medical records from 588 children and adolescents with T1D, tracking them from diabetes diagnosis until age 18. Over this period, they collected nearly 3,000 measurements of an important celiac disease antibody called TGA-IgA (anti-transglutaminase 2 IgA). They also recorded other antibody levels, including IgG antibodies against deamidated gliadin peptides (GLA-IgG), which are sometimes used in celiac disease testing.

Among the participants:

• 34 children (5.8%) were eventually diagnosed with celiac disease.
• Half had noticeable symptoms at diagnosis, while the other half were detected through screening.
• Two-thirds of CD cases were diagnosed within two years of T1D diagnosis.

Key Findings

1. The Best Antibody Cutoff for Biopsy Referral

The study found that a TGA-IgA level around 6.1 times the upper limit of normal was the most reliable indicator for recommending a biopsy. At this level:

• The test correctly identified 90.3% of true celiac cases (high sensitivity).
• It also minimized unnecessary biopsies in children without CD (80.4% accuracy).

2. Combining Antibody Tests Improves Accuracy

While TGA-IgA alone was useful, adding GLA-IgG (another celiac-related antibody) improved diagnostic precision. The combined approach increased the test’s overall reliability, making it better at distinguishing between children who truly had CD and those who did not.

3. Timing of Celiac Disease Diagnosis Matters

• Early CD diagnosis (within 2 years of T1D): Most children who developed CD soon after their diabetes diagnosis already had high TGA-IgA levels at the time of their T1D diagnosis.
• Late CD diagnosis (after 2 years): These children showed a slower, more gradual rise in TGA-IgA levels over time.

This suggests that early antibody testing in children newly diagnosed with T1D could help identify those at highest risk for celiac disease.

What This Means for Children with Type 1 Diabetes and Celiac Disease

For families managing T1D, this study offers important insights:

• Earlier Detection: Since many children develop CD soon after T1D diagnosis, screening at diabetes onset—and monitoring antibody levels—could lead to earlier detection and treatment.
• Fewer Unnecessary Biopsies: The proposed TGA-IgA cutoff (6.1x normal) helps doctors decide which children truly need a biopsy, reducing invasive procedures for those unlikely to have CD.
• Better Testing Strategies: Combining TGA-IgA with GLA-IgG improves accuracy, meaning fewer missed cases and fewer false alarms.

Why This Is Important for Celiac Disease Management

For children with both T1D and celiac disease, early diagnosis is crucial because:

• Untreated CD can worsen blood sugar control in diabetes.
• A gluten-free diet (the only treatment for CD) helps prevent long-term complications like nutrient deficiencies and growth delays.
• Many children with T1D and CD have no obvious symptoms, so relying on antibody testing is essential for timely diagnosis.

Conclusion

This study provides valuable guidance for doctors screening children with type 1 diabetes for celiac disease. By using a TGA-IgA threshold of 6.1 times the upper limit of normal, along with additional antibody testing, physicians can more accurately determine which children should undergo a biopsy. Early and precise detection means children with CD can start a gluten-free diet sooner, improving their overall health and diabetes management.

For families, these findings reinforce the importance of regular celiac screening in children with T1D—especially in the first few years after diabetes diagnosis—to catch the disease early, even before symptoms appear.

Read more at: academic.oup.com

Celiac.com 12/23/2024 - Celiac disease is an autoimmune disorder that affects the small intestine, making it difficult for the body to absorb essential nutrients. This condition can occur globally, especially in individuals with other autoimmune diseases like Type 1 diabetes. In West Africa, however, there has been little research on celiac disease’s prevalence in populations with Type 1 diabetes, which prompted this study to investigate its occurrence among Nigerian children and adolescents with diabetes.

Study Objectives and Design

The study aimed to explore how frequently celiac disease autoimmunity occurs in Nigerian children and adolescents diagnosed with Type 1 diabetes. Researchers examined over 100 young patients from pediatric endocrinology clinics across Nigeria, gathering data on socio-demographic factors and clinical details like symptom history and overall health. To detect celiac disease autoimmunity, the study screened for specific antibodies in blood samples. Those with elevated antibody levels were encouraged to undergo an endoscopy and a biopsy to confirm a celiac disease diagnosis.

Key Findings on Celiac Disease Autoimmunity

Among the participants with Type 1 diabetes, around 6% showed signs of celiac disease autoimmunity based on elevated antibody levels. All cases occurred in females, primarily between ages 3 and 12. Most of the affected children experienced gastrointestinal symptoms, including nausea, vomiting, diarrhea, and bloating, which are typical symptoms of celiac disease. A notable finding was that children diagnosed with Type 1 diabetes before age 10 were more likely to have celiac disease autoimmunity compared to those diagnosed later.

Regional and Gender-Based Patterns

This study highlighted potential regional trends, finding that most children with celiac disease autoimmunity were from northern Nigeria, which borders regions in North Africa where celiac disease is more prevalent. This geographical proximity may play a role in increased autoimmune conditions due to genetic similarities and environmental factors. Additionally, the study confirmed that celiac disease autoimmunity appears more frequently in females, consistent with broader findings in autoimmune research.

Challenges and Diagnostic Limitations

Although antibody tests are useful in suggesting celiac disease autoimmunity, a duodenal biopsy is necessary to confirm the diagnosis. However, due to limited healthcare resources in Nigeria, most children with high antibody levels couldn’t complete a biopsy. Given the expense and accessibility issues related to this procedure, the study relied on combined antibody testing to improve diagnostic accuracy. Despite these constraints, researchers could identify patterns and suggest that screening programs might help to better understand the prevalence of celiac disease among high-risk groups in Nigeria.

Comparisons with Other Regions

The study’s findings align with similar research in Europe and the Middle East, where celiac disease occurs in approximately 5% of children with Type 1 diabetes. However, in certain African and Middle Eastern countries, the prevalence is often higher, likely due to genetic and dietary factors, as well as varying diagnostic practices. For example, countries like Egypt and Morocco report higher prevalence rates in children with diabetes than observed in Nigeria, which could be due to regional differences in food consumption, healthcare access, or population genetics.

Implications for Health Practices in Nigeria

This study brings attention to the potential for undiagnosed celiac disease in the general Nigerian population, especially among children with Type 1 diabetes. For individuals with both diabetes and celiac disease, untreated symptoms can lead to poor nutrient absorption, impacting their diabetes management and overall health. Diagnosing and managing celiac disease in young diabetic patients could improve their quality of life and reduce health risks related to nutrient deficiencies.

Why These Findings Matter for Children with Type 1 Diabetes

For healthcare providers, this research underscores the importance of routine screening for celiac disease in children and adolescents diagnosed with Type 1 diabetes. Early detection can help families and medical teams address dietary adjustments, specifically a gluten-free diet, to prevent complications and manage symptoms effectively. This study encourages proactive healthcare approaches, particularly for those at higher risk, and emphasizes the need for accessible diagnostic tools. By raising awareness and improving screening practices, the healthcare community can work to address the significant but often overlooked burden of celiac disease.

Read more at: bmcgastroenterol.biomedcentral.com

Watch the video version of this article:

Celiac.com 01/25/2023 - Studies that have tried to measure the effects of a gluten-free diet on the clinical, biochemical and psychological condition of youths with both type 1 diabetes and celiac disease have delivered mixed results.

A team of researchers recently set out to evaluate the impact of gluten-free diet on growth, metabolic control and quality of life in children and adolescents with type 1 diabetes and celiac disease. 

The research team included Enza Mozzillo, Roberto Franceschi, Francesca Di Candia, Francesco Maria Rosanio, Letizia Leonardi, Ludovica Fedi, Valentina Rosà, Vittoria Cauvin, Adriana Franzese, and M. Loredana Marcovecchio. 

They are variously affiliated with theDepartment of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, Federico II University of Naples, Naples, Italy; the Department of Pediatrics, S. Chiara Hospital in Trento, Italy; the Pediatric Diabetology Unit, Pediatric Department, S. Chiara General Hospital inTrento, Italy; and the Department of Paediatrics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

The team first performed a systematic search of studies published in the last 15 years. They used PICOS framework to inform the selection process, and assessed evidence using the GRADE system.

Their systematic review included only studies of moderate-high evidence quality level and reporting data on objectively assessed adherence to a gluten-free diet. 

Their findings highlight pre-adult adherence to a gluten-free diet in youth with type 1 diabetes and celiac disease leads to regular growth, stable BMI, without any negative effect on HbA1c and insulin requirements.

Their main finding was that patients who followed a gluten-free diet experienced regular growth without any adverse increase in BMI. Moreover, the gluten-free diet does not negatively affect HbA1c and insulin, but is associated with higher post-meal glucose levels. 

Evidence from several studies indicate that a gluten-free diet is associated with better lipid profile and major quality of life and the psychological condition of juveniles with both type 1 diabetes and celiac disease. This study offers strong evidence that a gluten-free diet offers major benefits to juveniles with both type 1 diabetes and celiac disease.

Read more at Diabetes Research and Clinical Practice.

Celiac.com 04/11/2022 - Researchers and clinicians are just beginning to understand the many connections between celiac disease and diabetes. We've done a number of articles on links between celiac disease and diabetes.

We've talked about how a gluten-free diet might help lower diabetes risk. We've looked at the potential role of gluten in Type 1 Diabetes.

We've even asked if having type 1 diabetes mellitus and celiac disease automatically mean worse health and quality of life?

We know that rates of diabetes are much higher in celiacs than in the general population, and vice versa. We also know that non-diabetic patients often show celiac-specific humoral immunoreactivity at the time of their celiac disease diagnosis. What about diabetic patients? Do they show type 1 diabetes celiac-specific humoral immunoreactivity?

To find out, a research team recently looked at celiac-associated humoral autoimmunity in child, adolescent, and adult patients at the onset of type 1 diabetes (DM1) to see if those patients exhibit DM1 celiac-specific humoral immunoreactivity, as do non-diabetic celiac patients at first diagnosis.

The research team included Claudio Tiberti Aceliac disease, Francesca Panimolle BS, Margherita Bonamico MD, Blegina Shashaj MD, Tiziana Filardi MD, Federica Lucantoni BS, Raffaella Nenna MD, Francesco Costantino MD, Andrea Lenzi MD, and Susanna Morano MD. They are variously affiliated with the Department of Internal Medicine, University of Rome “Sapienza,” Rome, Italy; the Department of Pediatrics, University of Rome “Sapienza,” Rome, Italy; and the Department of Physiopathology, University of Rome “Sapienza,” Rome, Italy.

The team found IgA anti-transglutaminase autoantibodies (IgA-tTGAb) in more than 650 new-onset DM1 serum samples.  They then analyzed IgA-tTGAb-positive DM1 samples for IgG-tTG, deamidated gliadin (DGP), and actin antibodies, and compared the results against those from more than 80 screen-detected non-diabetic patients at the time of their celiac diagnosis.

In all, nearly thirteen percent of DM1 samples were positive for IgA-tTGAb, with patients 18 years or over showing lower autoantibody frequency, that's about 2.2 times more than in adult patients.

Meanwhile, compared with non-diabetic celiacs, IgA-tTGAb+ DM1 patients showed substantially lower IgA-tTGAb titers, IgG-tTGAb, and DGPAb frequency/titers, along with sharply lower average number of celiac-autoantibody positive results per patient. 

These results show that the age of diabetes onset is negatively associated with risk of celiac disease, that is, the lower age of DM1 onset, the higher the risk of developing celiac disease. Compared with the activity of non-diabetic patients at the time of celiac diagnosis, celiac-specific humoral immunoreactivity is sharply lower at the onset of DM1.

The team suggests that a general lower celiac-specific humoral immune response reflects a slower process of celiac disease development in DM1 patients, which is marked by nearly imperceptible gastrointestinal symptoms. 

This hypothesis is supported by an autoimmune diabetes study that shows a direct correlation between intensity of the humoral immune response and more prominent characteristics of insulin deficiency.*

Stay tuned for more stories on connections between celiac disease and diabetes.

Read more in Diabetes Care. 2012 Oct; 35(10): 2083–2085
 

*Buzzetti R, Di Pietro S, Giaccari A, et al. Non Insulin Requiring Autoimmune Diabetes Study Group High titer of autoantibodies to GAD identifies a specific phenotype of adult-onset autoimmune diabetes. Diabetes Care 2007;30:932–938 

Celiac.com 02/08/2022 - The numerous connections between celiac disease and diabetes have led many clinicians to screen diabetes patients for celiac disease, and vice versa. The case of a five year-old girl's recent celiac diagnosis during a diabetes study further highlights that connection.

Shane and Staci Vogel, an Iowa couple with a family history of diabetes, enrolled their daughter Kemper, 5, and son Knox, 2, in Sanford Health's PLEDGE study, a large-scale screening of children under age 6 for type 1 diabetes and celiac disease.

Fortunately, the study found no sign of diabetes in either child, but the process did lead to a celiac diagnosis for Kemper.

Kemper didn't have any clear symptoms of celiac disease at the time of her diagnosis, the family quickly moved to rid their home of gluten ingredients, and get her on a gluten-free diet.

Begun a year ago, with the modest goal of using a few clinics to test 1,000 children for diabetes and celiac disease, the PLEDGE project screened more than 2,000 children in its first year, study researcher Dr. Kurt Griffin told reporters.

The PLEDGE study has grown from just a few clinics to over forty-two, Griffin said, including all of Sanford Health clinics in Sioux Falls, among others.

According to Sanford's website, the study is now enrolling children under 6-years old, provided they are currently receiving annual checkups at Sanford Health, and are not diagnosed with type 1 diabetes.

Sanford is offering the study at no cost to families.

To learn more about the PLEDGE study and whether your child qualifies, call (877) 878-4825.

Read more in the Sioux Falls Argus Leader

Celiac.com 11/09/2021 - A team of investigators recently set out to determine if patients with type 1 diabetes mellitus (T1DM) are at an increased risk of developing celiac disease compared with the general population. 

Their study, “Threshold for Undergoing Celiac Disease Diagnosis in Pediatric Type 1 Diabetes Mellitus Patients” was presented at the American College of Gastroenterology 2021 conference. The investigative team included Laurel Wood, MD, and colleagues variously affiliated with the University of Chicago.

For the study, they reviewed chart data on patients under 21 years old who were diagnosed with both T1DM and celiac disease, and treated at University of Chicago. Data included patient diagnosis, pathologic results, serologic test results, and patient demographics.

In all, 52% of patients were female, 86% were white, 5% were Hispanic or Latino, 5% were Asian, 3% were black, and 6% were of unknown ethnicity.

The team found a total of sixty-three patients diagnosed with T1DM and celiac disease. Seven children diagnosed with T1DM who initially had negative celiac screening results became positive up to 7.25 years later, which shows the importance of regular screening.

Typical T1DM patients received first celiac disease screening within an average of 2.29 years after their T1DM diagnosis. The diagnoses of celiac disease included sixteen cases by serology alone (16), thirty-nine by duodenal biopsy (39), and eight others.

TTG and EMA showed a strong correlation, while high DGP IgA and DGP IgG were not necessarily the best indicators or duodenal mucosal damage in patients with T1DM.

To more fully understand the usefulness of celiac disease antibodies in predicting severity of disease in T1DM children, the team suggests studies with larger samples of T1DM patients with Marsh scores less than 3 and increased celiac disease serology.

They found that people with type 1 diabetes mellitus (T1DM) face a risk of developing celiac disease that is five to seven times higher than the general population.

Read more at hcplive.com
 

Celiac.com 11/16/2020 - Type 1 diabetes (T1D), is an autoimmune disease that affects about 1.6 million Americans. People with a family history of T1D face a 15 times higher risk of developing T1D than people without a family history. Up to 20% of those with T1D may also have celiac disease.

In an effort to redefine patient care in type 1 diabetes (T1D), Provention Bio, Inc., a biopharmaceutical company dedicated to intercepting and preventing autoimmune disease, has launched two complementary national disease state and screening education campaigns.

The programs, titled, "Connected by T1D" and "Type 1 Tested," are designed to help healthcare professionals, patients and relatives with elevated risk of T1D to better understand the importance of early-stage, pre-symptomatic disease screening for people with a family history of T1D.

Early blood screening for specific autoantibodies can spot early-stage T1D before any signs or symptoms appear.  Early diagnosis and treatment can help patients prepare in advance to live with diabetes, and may lower the risk of potentially deadly T1D-related problems, such as diabetic ketoacidosis. 

Both campaigns highlight the importance of early screening for patients at greater risk due to family history of T1D. "Connected by T1D" also focuses on the different stages of T1D, along with beta cell destruction that occurs months and years prior to the onset of symptoms. "Type 1 Tested" emphasizes that early testing gives parents, patients and their doctors the knowledge needed to prepare in advance for clinical T1D, and make decisions to reduce the chances of diabetic ketoacidosis and other serious problems. 

Both campaigns encourage early and routine autoantibody screening for people with family history of T1D.

"We hope this national educational effort will inspire behavioral change by challenging the standard clinical practice with respect to T1D, and encourage autoantibody screening for relatives of people living with the disease," said Eleanor (Leni) Ramos, MD, CMO, Provention Bio. 

Provention Bio, Inc. (Nasdaq: PRVB) is a biopharmaceutical company whose main investigational drug, teplizumab, designed to delay or prevention of insulin-dependent type 1 diabetes (T1D) in at-risk patients during the pre-symptomatic phase of the disease is currently under review by FDA.

Efforts to screen and preemptively treat autoimmune diseases like T1D hold promise of similar approaches to screening and treating celiac disease, especially in first degree relatives, before damage can begin.

Read more at PRnewswire.com. Stay tuned for more on this and related stories.

Celiac.com 10/20/2020 - Doctors diagnosing children for type 1 diabetes are increasingly finding other autoimmune conditions that can complicate the outlook for these patients. A team of researchers recently set out to study rates of comorbid autoimmune diseases, including celiac disease, and type 1 diabetes mellitus (T1D) in children.

Rates of type 1 diabetes mellitus (T1D) in children are on the rise, but it's unclear what relationship, if any, this might have with other coexistent autoimmune conditions, since diabetes onset is not well understood. 

The team wanted to assess the incidence of T1D, and the rates of coexistent autoimmune illnesses, from the onset of diabetes mellitus in children over a nine year study period. In their retrospective study, the team calculated incidence rate for T1D as the total number of all newly diagnosed cases per 100,000 population in people between 0 and 18 years of age. 

The team studied 264 boys and 229 girls between 0 and 18 years old with newly diagnosed with T1D in one of the Polish centers from 2010–2018. They determined diagnoses for related autoimmune illnesses from initial data recorded when patients first received diagnosis for T1D.

The team found that the standardized incidence rate of T1D in children rose 170% over the 9-year study period, while the incidence rate ratio rose 4% per year. 

As rates of T1D have risen rapidly in all children of all ages in recent years, so, too have rates of the autoimmune diseases that frequently accompany these conditions. Having an additional autoimmunity disorder is a serious burden for patients with new-onset T1D. 

Stay tuned for more information on the challenges faced by children with more than one auto-immune disease.

Read more in Front Endocrinol (Lausanne). 2020; 11: 476.

Reference:
Głowińska-Olszewska B, Szabłowski M, Panas P, et al. Increasing co-occurance of additional autoimmune disorders at diabetes type 1 onset among children and adolescents diagnosed in years 2010-2018—single-center study. Front Endocrinol. Published online August 6, 2020. doi:10.3389/fendo.2020.00476.

The research team included Barbara Głowińska-Olszewska, Maciej Szabłowski, Patrycja Panas, Karolina Żoła̧dek, Milena Jamiołkowska-Sztabkowska, Anna Justyna Milewska, Anna Kadłubiska, Agnieszka Polkowska, Włodzimierz Łuczyński, and Artur Bossowski. They are variously affiliated with the Department of Pediatrics, Endocrinology, Diabetology With Cardiology Division, Medical University of Bialystok, Białystok, Poland; the Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Białystok, Poland; the Department of Statistics and Medical Informatics, Medical University of Bialystok, Białystok, Poland; and the Department of Medical Simulations, Medical University of Bialystok, Białystok, Poland.

Celiac.com 06/22/2020 - Since 2004 data collected prospectively by The Environmental Determinants of Diabetes in the Young (TEDDY) study group has helped researchers to better understand T1D, and associated autoimmune conditions, like celiac disease. TEDDY is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 

Celiac disease and T1D share a number of genetic factors. Seeking to explain why some children with high-risk genes develop T1D or celiac disease, while most do not, the TEDDY team monitors study subjects for both T1D and celiac disease. 

TEDDY research has already shown that genetically predisposed children who eat gluten at, or above, certain levels in early childhood, had higher rates of celiac disease. "An interesting finding from TEDDY has been how early the autoimmune destruction of insulin-producing cells begins–often in the initial two years of life," said study TEDDY co-chair Marian Rewers, MD, PhD, a professor of pediatrics and medicine and executive director of the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine.

The TEDDY study follows infants with high T1D risk factors for 15 years to look for certain beta-cell autoantibodies and diabetes. TEDDY has also looked at biomarkers that indicate faster or slower progression to diabetes after autoimmune destruction begins. "While T1D and celiac disease share a lot of genetic characteristics, there are intriguing differences in the ways these diseases develop and progress," says Dr. Rewers, adding that "TEDDY research and discovery will help drive the "design of future trials to prevent both T1D and celiac disease."

TEDDY is looking to uncover viruses and nutritional factors that work with genes to initiate destruction of the beta cells by the immune system, which is signaled by the appearance of islet autoantibodies. Ultimately, TEDDY investigators are looking to uncover a way to prevent both diabetes and celiac disease in children. 

The latest information from TEDDY highlights potential "triggers" for the autoimmune process that generates type 1 diabetes (T1D), and how those triggers engage  in children with with genetic risk factors for T1D. 

That information is highlighted in the "Update from the TEDDY Study" symposium today at the American Diabetes Association's (ADA's) 80th Virtual Scientific Sessions. 

Among TEDDY's latest findings are two new papers, Longitudinal Metabolome-Wide Signals Prior to the Appearance of a First Islet Autoantibody in Children Participating in the TEDDY Study; and Distinct Growth Phases in Early Life Associated With the Risk of Type 1 Diabetes.

Read the original press release at PRNewswire.com. Stay tuned for more on TEDDY and related stories.

Celiac.com 06/09/2020 - What can science tell us about celiac disease screening rates and glycemic outcomes of a gluten-free diet in patients with type 1 diabetes who are asymptomatic for celiac disease?

A team of researchers recently set out to assess the issue and get some answers. The research team included Farid H. Mahmud, Antoine B.M. Clarke, Kariym C. Joachim, Esther Assor, Charlotte McDonald, Fred Saibil, Heather A. Lochnan, Zubin Punthakee, Amish Parikh, Andrew Advani, Baiju R. Shah, Bruce A. Perkins, Caroline S. Zuijdwijk, David R. Mack, Dror Koltin, Emilia N. De Melo, Eugene Hsieh, Geetha Mukerji, Jeremy Gilbert, Kevin Bax, Margaret L. Lawson, Maria Cino, Melanie D. Beaton, Navaaz A. Saloojee, Olivia Lou, Patricia H. Gallego, Premysl Bercik, Robyn L. Houlden, Ronnie Aronson, Susan E. Kirsch, William G. Paterson, and Margaret A. Marcon. They are all affiliated with the American Diabetes Association.

The team conducted celiac disease screening on asymptomatic patients from 8 to 45 years of age. To assess changes in HbA1c, they randomly assigned biopsy-confirmed celiac disease patients to a gluten-free diet or gluten-containing diet (GCD), along with one year of glucose monitoring.

Adults tested positive for celiac disease antibodies more often than children with lower rates of prior celiac disease screening. 

Twenty-seven subjects went on the gluten-free diet, while twenty-four followed the gluten-containing diet. The team saw no HbA1c differences between the groups, though gluten-free patients showed more substantial glucose increases after meals.

Celiac disease is common in asymptomatic patients with type 1 diabetes, and the team advises clinicians to be vigilant about starting those patients on a gluten-free diet.

Read more in Diabetes Care 2020 May; dc191944.