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Found 5 results

  1. Celiac.com 06/26/2013 - Do people with type 1 diabetes (T1D) and celiac disease die younger than people with T1D who do not have celiac disease? Do celiac patients without T1D live longer than those with T1D? Currently, not much is known about how celiac disease might influence mortality rates in people with T1D. A team of researchers recently set out to examine rates of death in patients with both T1D and celiac disease. The researchers include K. Mollazadegan, D.S. Sanders, J. Ludvigsson, and J.F. Ludvigsson. The are variously affiliated with the Clinical Epidemiology Unit of the Department of Medicine, Solna, Karolinska Institutet, and with St. Erik Eye Hospital, Karolinska Institutet in Stockholm, Sweden. The research team set out to examine mortality in patients with both type 1 diabetes (T1D) and celiac disease. For their study, the team used biopsy reports to identify all people diagnosed with celiac disease between 1969 and 2008, within all 28 pathology departments in Sweden. They defined T1D as a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009 in individuals aged ≤30 years. Their follow-up showed 960 patients with both T1D and celiac disease. For each individual with T1D and celiac disease, they selected up to five subjects with T1D alone (no celiac disease) as a reference group of 4608 individuals. They then matched all reference individuals for sex, age and calendar period of diagnosis. The team used stratified Cox regression analysis with celiac disease as a time-dependent covariate to estimate the risk of death in patients with both T1D and celiac disease compared to those with T1D alone. The results showed that celiac disease was not a risk factor for death in patients with T1D in the first 5 years after celiac disease diagnosis [hazard ratio (hazard ratio) 0.87, 95% confidence interval (CI) 0.43-1.73]. However, with the passage of time, that reality changed, and mortality risk rose in direct relation to follow-up time (5 to In the end, for people with T1D, having a celiac disease diagnosis for at least 15 years was associated with a 2.80 times greater risk of death (95% CI 1.28-6.12). Source: J Intern Med. 2013 May 23. doi: 10.1111/joim.12092.
  2. Celiac.com 05/22/2017 - After their seven-month-old baby died weighing less than 10 pounds, a mother and father in Beveren, Belgium, are standing trial on charges that they starved the child by negligently providing an alternative gluten-free diet, with no medical supervision. The couple, who ran a natural food store, put their son Lucas on an alternative gluten-free, lactose-free diet, which included quinoa milk, despite doctors describing it as unsuitable for developing infants. According to child gastroenterologist Elisabeth De Greef, from the University Hospital of Brussels, feeding quinoa milk and other such foods to infants is absolutely wrong. She says that "These kinds of milk, which you can buy in a supermarket, do not contain the necessary proteins, minerals and vitamins. They are not adjusted to infants and thus unsuitable." Lucas' mother said in a statement that "Lucas had an eating disorder. He got cramps when he was fed with a bottle and his parents tried out alternatives. Oat milk, rice milk, buckwheat milk, semolina milk, quinoa milk." These are all products the couple sold at their store. At the beginning of the trial, public prosecutors blamed the couple for their son's death. Prosecutors claim that the couple made their "own diagnosis that their child was gluten intolerant and had a lactose allergy," without any input from doctors. In fact, prosecutors allege that the couple kept the child away from doctors altogether. "Not a single doctor had a dossier about Lucas and child protection services did not know about them," said the public prosecutor. The infant's diet, said prosecutors, "led to him being less than half the expected weight for a boy his age," at the time of his death in June 6, 2014. An autopsy showed that Lucas' stomach was totally empty at the time of his death. Prosecutors say the parents did not seek medical attention, even when Lucas was gasping for air in the days before he died. When Lucas was in the final throes of starvation, and the parents finally did take action, prosecutors say that they compounded the child's medical crisis by driving to a homeopathic doctor on the other side of the country, instead of going to the nearest hospital. In their defense, Lucas's father, claimed the couple never took Lucas to a doctor "because we never noticed anything unusual." In fact, the parents believed Lucas had an eating problem, says the couple's lawyer. Under questioning, Lucas' tearful mother said that the couple never "wished for the death of our son." She also stated that Lucas ometimes…gained a little weight, sometimes he lost a little." Yet according the public prosecutor the actions by the couple amount to "intentionally denying food" to the boy. For now, the trial in this tragic case continues, with a verdict set for June 14. Read more: Metro.co.uk
  3. Lancet 2001; 358: 356-61 Celiac.com 08/10/2001 - In line with past studies on the mortality rate of people with celiac disease, the results of a new study conducted by Dr. Giovanni Corrao (Cattedra di Statistica Medica, Università di Milano-Bicocca, 20126 Milano, Italy), et. al., indicate that the death rate among people with celiac disease is double that of the normal population. The prospective cohort study examined 1,072 adults who were diagnosed with celiac disease between 1962 and 1994, and their 3,384 first-degree relatives. The mortality rates by 1998 among both groups were compared to that of the normal population. Their findings show that 53 people in the celiac disease group died compared with the 25.9 deaths that were expected (Standardized Mortality Ratio - SMR). Unlike past studies, however, this one also looked for different patterns of clinical presentation of the disease. For example, the results indicate that within three years of diagnosis there was a significant increase in the mortality rate for those who presented symptoms of malabsorption. This same increase was not seen in those who were originally diagnosed because of minor symptoms, or via an antibody screening. The SMR also increased when there was a delay in diagnosis, and when a gluten-free diet was not followed. Non-Hodgkin lymphoma was the main cause of death, and no excess in mortality rate was seen in the groups first-degree relatives. Conclusion: Prompt diagnosis and dietary treatment will decrease the mortality rate of people with celiac disease. More studies are needed regarding asymptomatic people with celiac disease and their risk of intestinal lymphoma.
  4. Celiac.com 03/02/2011 - New blood screening tests have improved rates of diagnosis for celiac disease in recent decades, but better diagnosis has not reduced celiac-associated deaths, according to a report by UK researchers in the American Journal of Gastroenterology. After serologic tests became available, there was an approximate tenfold increase in the numbers of people being diagnosed with celiac disease. Intuitively, one would expect this increase in diagnosis to be followed by a decrease in celiac-related deaths. The idea being that earlier diagnosis means earlier treatment with gluten-free diet, and, ideally, less associated conditions and deaths. However, the newest study in this area shows evidence of any change in all-cause mortality among people with celiac disease. That means that even with better, earlier diagnosis, people with celiac disease are still dying at the same rates as before. Researcher Dr. Matthew J. Grainge, of the University of Nottingham, told Reuters Health that his team "found that people with celiac disease have a 37% increase in all-cause mortality compared with the general population." His team found that people diagnosed with celiac disease since 2000 have a similar mortality risk as those diagnosed earlier despite the introduction of serological tests, "which has probably resulted in milder cases being identified," Grainge said. For their study, the research team reviewed data on 1092 celiac disease patients diagnosed from the late 1950s onward, and who had been followed for a minimum of two years. The team examined outcomes from 1978 until death or through the end of 2006. All study subjects were diagnosed at a single center and the study covered both the pre- and post-serology era. The study covered more than 10,000 person years of follow-up, and tallied a total of 142 deaths. The study revealed a significantly increased all-cause standardized mortality ratio (SMR) of 1.37. This was higher for men (SMR, 1.86) than for women (SMR, 1.10). Study subjects had higher rates of death from cancer (SMR, 1.61) digestive (SMR, 2.19) and respiratory diseases (SMR, 1.57) compared to the general population. In all, there were 21 deaths from respiratory diseases, 11 of those from pneumonia. According to the research team, this data supports current guidelines recommending pneumococcal vaccination for people with celiac disease. In conclusion, the researchers note that the results may offer doctors "an opportunity to reduce mortality following pneumococcal infection by increasing the uptake of vaccination against this pathogen as vaccination rates are currently well below 50%." Source: Am J Gastroenterol; January 18, 2011.
  5. Arch Intern Med. 2003;163:1566-1572. Ulrike Peters, PhD, MPH; Johan Askling, MD; Gloria Gridley, MS; Anders Ekbom, MD, PhD; Martha Linet, MD Celiac.com 07/30/2003 - The following abstract paints a fairly bleak picture for those of us with celiac disease; however, after taking a closer look at it I believe that it has some serious limitations that should not be overlooked, and have likely produced skewed or irrelevant results. For example, the study does not indicate whether or not the patients in it followed a strict gluten-free diet. Other studies have shown that the mortality risk for celiacs decreases to that of the normal population when a gluten-free diet is followed for at least five years, and that it is also affected by how soon the diagnosis is made and how soon treatment begins. It is well known that not following a gluten-free diet will increase a celiacs risk of death by many causes to many times that of the normal population, which is precisely why it is so important to include such information in studies of this type. In my opinion doing a study like this and not including such data is like doing a study on diabetes where perhaps half or more people in the study do not take insulin but ought to, and then publishing the ultra-high mortality rate that would be its outcome: "Conclusion: Diabetics have a 20-fold mortality rate over the normal population." The conclusion would clearly not be true for those who took their insulin. Additionally the time period that is covered by this study, 1964-1993, could be considered the dark ages of celiac disease, even in Europe (we actually may be just entering the Renaissance age for celiac disease here in the USA, but this could be argued!). Many doctors during this time did not stress enough to their patients the importance of following a strict gluten-free diet, just as many still do not even do this day. My doctor didnt. He just diagnosed me and said I shouldnt eat gluten (as opposed to telling me that it could kill me if I kept eating it), and he didnt even explain to me HOW to avoid it! Is it possible that some of the folks in this study, diagnosed as far back as 1964, might have had similar experiences with their doctors? I would be willing to bet that at least 50% of the people in this study (if not more) were not following a strict gluten-free diet, or were not following the diet at all. If this is true, it is kind of like studying a group of diabetics whose only treatment was to be told by their doctors that they should avoid sugar, which seems absurd if you think about it. Last, the study has considerable bias in that it recruited only hospitalized celiacs, presumably because they were already significantly ill, and those who never made it into a hospital were excluded. It reports findings of auto-immune diseases and small bowel/lymphomaexcesses--these are already well known--but what other researchers may disagree with is the scale of the excess--SMR is always a very crude method ofexpressing this in such studies. - Scott Adams (special thanks to Dr. Geoff Helliwell for his comments on this study) Abstract : "Background: Patients with celiac disease have an increased risk of death from gastrointestinal malignancies and lymphomas, but little is known about mortality from other causes and few studies have assessed long-term outcomes." "Methods: Nationwide data on 10,032 Swedish patients hospitalized from January 1, 1964, through December 31, 1993, with celiac disease and surviving at least 12 months were linked with the national mortality register. Mortality risks were computed as standardized mortality ratios (SMRs), comparing mortality rates of patients with celiac disease with rates in the general Swedish population." "Results: A total of 828 patients with celiac disease died during the follow-up period (1965-1994). For all causes of death combined, mortality risks were significantly elevated: 2.0-fold (95% confidence interval [CI], 1.8-2.1) among all patients with celiac disease and 1.4-fold (95% CI, 1.2-1.6) among patients with celiac disease with no other discharge diagnoses at initial hospitalization. The overall SMR did not differ by sex or calendar year of initial hospitalization, whereas mortality risk in patients hospitalized with celiac disease before the age of 2 years was significantly lower by 60% (95% CI, 0.2-0.8) compared with the same age group of the general population. Mortality risks were elevated for a wide array of diseases, including non-Hodgkin lymphoma (SMR, 11.4), cancer of the small intestine (SMR, 17.3), autoimmune diseases (including rheumatoid arthritis [sMR, 7.3] and diffuse diseases of connective tissue [sMR, 17.0]), allergic disorders (such as asthma [sMR, 2.8]), inflammatory bowel diseases (including ulcerative colitis and Crohns disease [sMR, 70.9]), diabetes mellitus (SMR, 3.0), disorders of immune deficiency (SMR, 20.9), tuberculosis (SMR, 5.9), pneumonia (SMR, 2.9), and nephritis (SMR, 5.4)." "Conclusion: The elevated mortality risk for all causes of death combined reflected, for the most part, disorders characterized by immune dysfunction."
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