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Found 8 results

  1. Celiac.com 10/03/2016 - It's hard for researchers to figure out the exact rate of celiac disease, in part because the disease so often presents a range of atypical symptoms. Most people with celiac disease suffer from classic gastrointestinal symptoms, but many patients may also be asymptomatic or have extra intestinal symptoms. A team of researchers recently set out to assess celiac disease rates in patients with epilepsy, align with determining the effect of a gluten-free diet on seizure control in these patients. The research team included Homayoon Bashiri, Darioush Afshari, Nosrat Babaei, and Mohammad R. Ghadami. They are variously affiliated with the Department of Internal Medicine, and the Sleep Disorders Research Center at Kermanshah University of Medical Sciences in Kermanshah, Iran. For their study, the team assessed patients with epilepsy in Imam Reza and Farabi Hospitals, Kermanshah, Iran. The team first screened patients screened based on results of immunoglobulin A antiendomysial (IgA) antibodies. In patients with positive screens for IgA antibodies, the team took 2–3 endoscopic small bowel biopsies from the distal duodenum to confirm celiac-related changes. People with celiac disease received a gluten-free diet for 5 months, during which time the researchers regularly recorded patient seizure activity. Of the 113 patients with epilepsy, the team diagnosed seven patients (6%) with celiac disease. After 5 months of instituting a gluten-free diet, 6 patients had their seizures completely under control, and were able to discontinue anti-epileptic drugs. In one patient, dosage of anticonvulsant drugs was cut in half, seizures were also controlled. These results showed that about 6% of epileptic patients were positive for celiac disease, and that these patients see significant improvement in seizure control on a gluten-free diet. Source: Adv Clin Exp Med 2016, 25, 4, 751–754
  2. Celiac.com 01/05/2015 - Doctors recommend medical follow-up of celiac disease patients for gluten-free diet (GFD) adherence monitoring and complication detection. But, what happens to celiac kids who don’t get good medical follow-up? A team of researchers recently tried to figure out how the LTFU kids fared health-wise compared to kids who did receive follow-up, and what barriers the LTFU kids might face in successfully following a gluten-free diet. The research team included L. Barnea, Y. Mozer-Glassberg, I. Hojsak, C. Hartman, and R. Shamir. They are variously affiliated with the Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva and the Sackler Faculty of Medicine at Tel-Aviv University in Tel Aviv, Israel. They had previously shown that 35% of children with celiac disease were lost to follow-up (LTFU), that is, they did not receive follow-up care for their celiac disease. The study team used a telephone questionnaire to assess 50 LTFU patients regarding frequency of follow-up, serology testing, and adherence to GFD measured by validated Biagi score. They had fifty two regular follow-up patients serve as a control group. The results showed that the LTFU patients had poor adherence to GFD, with an average Biagi score of 2.0 ± 1.4, compared to control scores of 3.0 ± 1.0 (p < 0.001). Only 22% of LTFU performed periodic celiac serology testing compared to 82% of the control group (p < 0.001). Fifty percent of the LTFU kids had higher prevalence of positive celiac serology tests, compared to 25% of controls, (p = 0.01). Just 24% of LTFU kids were National Celiac Association members, compared with 44% of control kids (p = 0.05). Regression analysis showed positive relationships between LTFU and poor adherence to GFD (R2 = 0.26737, p = 0.001), older age at diagnosis (R2 = 0.30046, p = 0.03), and non-membership in a celiac association (R2 = 0.18591, p = 0.0001). So, when the dust settled, the study showed that children LTFU were more likely to not follow a strictly gluten-free diet, and to have positive blood tests for anti-gluten antibodies. Accordingly, the team recommends that risk factors for LFTU be identified and addressed in order to improve patient care. Source: Digestion. 2014 Dec 19;90(4):248-253
  3. Celiac.com 02/27/2014 - For many people with celiac disease, one of the numerous downsides of the condition is the constant threat of an adverse reaction triggered by accidental gluten consumption. Because reactions to gluten ingestion can be severe for some celiac patients, many clinicians are looking to see if anything can be done to lessen the effects gluten reactions in celiac patients once they have started. A team of researchers sought to provide at least one possible answer by looking into the safety and efficacy of Aspergillus niger prolyl endoprotease (AN-PEP) to lessen effects gluten reactions in celiac patients. The researchers included G.J. Tack, J.M. van de Water, M.J. Bruins, E.M Kooy-Winkelaar, J. van Bergen, P. Bonnet, A.C. Vreugdenhil, I. Korponay-Szabo, L. Edens, B.M. von Blomberg, M.W. Schreurs, C.J. Mulder, and F. Koning. They are all affiliated with the Department of Gastroenterology and Hepatology, VU University Medical Centre, 1007 MB Amsterdam, The Netherlands. For their study, the team enrolled 16 adults with celiac disease as confirmed by positive blood test and biopsy-confirmed subtotal or total villous atrophy. All patients were following a strict gluten-free diet, and showed normalized antibodies and mucosal healing classified as Marsh 0 or I. In their randomized double-blind placebo-controlled pilot study, the team had patients consume wheat toast, totaling about 7 grams of gluten per day, with AN-PEP for a two-week safety phase. After a two-week washout period with adherence of the usual gluten-free diet, 14 patients were randomized to receive gluten with either AN-PEP or placebo for there two-week efficacy phase. Baseline measurements included complaints, quality-of-life, serum antibodies, immuno-phenotyping of T-cells and duodenal mucosa immuno-histology. The team collected both serum samples and quality of life questionnaires during and after the safety, washout and efficacy phase. They conducted duodenal biopsies after both safety and efficacy phases. The primary endpoint was a change in histological evaluation according to the modified Marsh classification. None of the sixteen adults in the study suffered serious adverse events, and no patients withdrew during the trial. Overall scores for the gastrointestinal subcategory of the celiac disease quality (CDQ) remains fairly high throughout the study, indicating that AN-PEP was well tolerated. Through the efficacy phase, CDQ scores for patients consuming gluten with placebo or gluten with AN-PEP remained largely unchanged, and researchers observed no differences between the groups. Moreover, neither the placebo group nor the AN-PEP group developed significant antibody titers, and IgA-EM concentrations remained negative for both groups. The team excluded two patients from entering the efficacy phase because their mucosa showed an increase of two Marsh steps after the safety phase, even though their serum antibodies remained undetectable. A total of 14 patients were considered histologically stable on gluten with AN-PEP. Also after the efficacy phase, the team saw no significant deterioration in immunohistological and flow cytometric values between the group consuming placebo compared to the group receiving AN-PEP. Furthermore, compared to baseline, after two weeks of gluten four out of seven patients on placebo showed increased IgA-tTG deposit staining. In the seven patients receiving AN-PEP, one patient showed increased and one showed decreased IgA-tTG deposits. AN-PEP appears to be well tolerated. However, the primary endpoint was not met due to lack of clinical deterioration upon placebo, impeding an effect of AN-PEP. Source: World J Gastroenterol. 2013 Sep 21;19(35):5837-47. doi: 10.3748/wjg.v19.i35.5837.
  4. Celiac.com 09/19/2012 - Researchers have documented rising rates of celiac disease in patients with type 1 diabetes (T1D). A research team recently tried to assess the effect of celiac disease on growth and glycemic control in patients with T1D, and to determine the effects of a gluten-free diet on these parameters. The research team included I. Taler, M. Phillip, Y. Lebenthal, L. de Vries, R. Shamir, and S. Shalitin. They are affiliated with the Department of Pediatrics B, Schneider Children's Medical Center of Israel in Petach Tikva, Israel. To do so, they conducted a longitudinal retrospective case-control study, in which they reviewed the medical data on 68 patients with T1D and duodenal-biopsy-confirmed celiac disease. They looked at weight, height, hemoglobin A1c (HbA1c), frequency of diabetic ketoacidosis (DKA), and severe hypoglycemic events before and after diagnosis and treatment of celiac disease. They then compared their findings with 131 patients with T1D alone, who were all matched for age, gender, and duration of diabetes. In all, 5.5% patients with T1D who attended the center during the study period were diagnosed with celiac disease, while 26% of the patients with celiac disease were symptomatic. The data showed no significant differences in glycemic control or frequency of severe hypoglycemia or DKA events between the study group and control subjects. Body mass index-standard deviation score (SDS), height-SDS, and HbA1c values were insignificantly higher in the control group than in the study group, and similar in celiac disease patients with good or fair/poor adherence to a gluten-free diet during follow-up. Patients with T1D and celiac disease and following a gluten-free diet have growth and metabolic control similar to those with T1D with no celiac disease. To determine whether a gluten-free diet is appropriate for asymptomatic celiac patients or only symptomatic patients must be assessed against possible short- and long-term consequences of no intervention, and the decision should be based on more evidence from larger randomized studies. Source: Pediatr Diabetes. 2012 May 7. doi: 10.1111/j.1399-5448.2012.00878.x.
  5. Celiac.com 11/28/2011 - Celiac disease often results in "leaky" intestinal mucosa. This development may involve changes in hydrophobicity of the mucus surface barrier along with changes of the epithelial barrier. A team of researchers recently compared bio-physical aspects of gastrointestinal mucosa of celiac patients with control subjects, along with the effects of gluten free diet on each group. The research team included Stefania Bertolazzi, Francesco Lanzarotto, Barbara Zanini, Chiara Ricci, Vincenzo Villanacci, and Alberto Lanzini. The team set out to compare duodenal hydrophobicity as an index of mucus barrier integrity in 38 patients studied before and 68 patients during gluten-free diet, and in 90 control subjects. They also checked for regional differences of hydrophobicity in the gastro-intestinal tract. The team gauged hydrophobicity by measuring the contact angle (CA) (Rame Hart 100/10 goniometer) created by a single drop of water applied to intestinal mucosal biopsies. Once the team pooled the results and evaluated the control groups, patients with histologically normal duodenal biopsies showed significantly higher CA (620 + 90) than patients with biopsies showing Marsh 1-2 (580 + 100; p<0.02) and Marsh 3 lesions (570+ 100; p<0.02). Among the control group, the action sequence of hydrofobicity along the gastrointestinal tract follows the pattern: gastric antrum> corpus> rectum> duodenum> oesophagus> ileum. From these results, the team concludes that people with celiac disease experience reduced hydrophobicity of duodenal mucous layer, and a reduced ability to repel luminal contents. This may may contribute to the increased intestinal permeability seen in celiac disease. This change in hydrofobicity corresponds to the severity of the mucosal lesions in the patient, and is not completely reversed by gluten-free diet. Source: BMC Gastroenterology 2011, 11:119 doi:10.1186/1471-230X-11-119
  6. Celiac.com 11/06/2007 - This study investigated the effect of screening detected celiac disease in type I diabetic children in a multi-center case-control fashion. The research team consisted of B Rami, Z Sumni, E Schober et al from Austria, Czech Republic, and Slovenia, among other European countries. The team compared 98 diabetics with silent celiac disease to 196 control diabetics without celiac matched for age, sex, diabetes duration. Mean age at diabetes diagnosis was 6.5 yrs, celiac diagnosis was 10.0 yrs. Celiac screening included yearly antibody testing and positive patients underwent biopsy. Hemoglobin A1c, hypoglycemia, ketoacidosis, insulin dosage, body-mass index, and height did not differ between cases and controls at celiac diagnosis or after a mean follow-up of 3.3 years. After diagnosis of celiac disease, weight gain was diminished in boys with celiac disease compared to their controls. Although a clear link between type I diabetes and increased risk of celiac disease is established, the benefit of a gluten-free diet is unclear in these children. This study followed 98 patients with diabetes and silent celiac for a mean of 3.3 years and compared them to 196 controls. This is the largest, best designed case-control study to date and it did not demonstrate any significant differences between the two groups, except for a decreased Body Mass Index (BMI - though still greater than non-diabetic, control children) in males after diagnosis. What is more intriguing is that at diagnosis, no significant differences in height, BMI, HbA1c, insulin need, or hypoglycemia events were seen, questioning the metabolic significance of silent celiac disease. In this study, it is difficult to estimate the duration of silent celiac disease prior to diagnosis. Although, given the fact that these patients were asymptomatic and their mean diabetes duration was 3.6 years, it likely implies that silent celiac disease was present for a few years. The data regarding the benefit of a gluten-free diet in screening detected celiac disease in type I diabetic children is scant but is slowly increasing. Numerous psychological (burden of gluten free diet in addition to diabetic diet), cost (of diet), and ethical issues (potential long-term benefits of gluten-free diet, compliance with diet) exist regarding these children and hopefully this question will be answered soon and with good, convincing data. Journal of Pediatric Gastroenterology and Nutrition, 41:317-321, 2005
  7. Arch Dis Child 2004;89:871-876. Celiac.com 07/12/2005 – Australian researchers have determined that a gluten-free diet in children with Type 1 diabetes mellitus and celiac disease can improve both growth and diabetes control. In the study 21 children (mean age 7.5 years) with both conditions went on a gluten-free diet for 12 months, and their growth and insulin dosages were carefully measured and compared with that of two matched diabetic, non-celiac controls. The group on a gluten-free diet showed significant increases in weight and body mass index compared with the control group, although an increase in height found in the study was not found to be significant. At the time of diagnosis insulin dosages for the celiac disease group were less than that of the control group, but became similar to the controls once a gluten-free diet was started—although the increase in insulin dosage had no effect on HbA1c levels. The researchers conclude: “Identification and dietary treatment of celiac disease in children with diabetes improved growth and influenced diabetic control. Evaluation of the outcome of treatment of celiac disease in diabetics should include assessments of gluten intake.” Obviously all children (and everyone) with celiac disease should be on a gluten-free diet, but what is noteworthy about this study is that a connection was found between insulin levels, diabetes control, and the gluten-free diet.
  8. Diabetes Care 2002;25:1111-1122. Celiac.com 08/08/2002 - A recent study conducted by Dr. David B. Dunger (Addenbrookes Hospital in Cambridge) and colleagues found that children with type 1 diabetes and latent celiac disease who were put on a gluten-free diet showed significant improvement in their metabolic control and growth. The study, which was published in the July issue of Diabetes Care, looked at 11 children with type 1 diabetes and who were diagnosed with celiac disease using anti-gliadin and anti-endomysial antibodies and a biopsy for confirmation. The group with celiac disease had a significantly lower mean BMI standard deviation score (SDS) than that of a control group of 22 age and sex-matched children with diabetes who did not have celiac disease. The mean height SDS and C-peptide levels in the two groups were similar, while the mean HbA-1-c was lower (better) in the group with celiac disease. After one year on a gluten-free diet the group with celiac disease improved its mean BMI score to that of the control group, and its HbA-1-c score went down (improved), while the control groups HbA-1-c score increased (worsened). The researchers conclude that more studies are needed to support their findings that a gluten-free diet significantly improves glycemic control in children with type 1 diabetes and celiac disease.
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