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Celiac.com 01/11/2012 - In an effort to understand how delayed celiac disease diagnosis became the norm for most patients over the last few decades, a research team conducted a study to assess the issue. Their study also looked at how delayed diagnosis affects health-related quality of life (HRQoL) for those with celiac disease, and considered differences with respect to sex and age. For the study, the team collaborated with the Swedish Society for Coeliacs to send a questionnaire to 1,560 randomly-chosen members, divided equally by age and sex. A total of 1,031 members (66%) responded. The team first measured HRQoL using the EQ-5D descriptive system, then translated the results to quality-adjusted life year (QALY) scores. The team then compared the results against the results from a survey of the general population. There was some good news and some bad news. The good news is that, while the average QALY score during the year before treatment was 0.66, it improved after diagnosis and treatment to 0.86, which is better than that the score of 0.79 for the general population. The bad news is that they found the average person with celiac disease faced a delay in diagnosis of 9.7 years from the first symptoms, and 5.8 years from the first doctor visit. The team concede that the delay has been reduced over time for some age groups, but contend that it still remains unacceptably long for large numbers of people. Untreated celiac disease results in poor HRQoL, which improves or exceeds that of the general population if diagnosed and treated. Reducing the delay in diagnosing celiac disease will go a long way toward reducing the burden of celiac disease. To do so, they say it is necessary to raise awareness of celiac disease as a common health problem, and to intensify diagnosis practices. This may, the note, make mass-screening for celiac disease an desirable option in the future. Authors: Fredrik Norstrom, Lars Lindholm, Olof Sandstrom, Katrina Nordyke, Anneli Ivarsson Source: BMC Gastroenterology 2011, 11:118. doi:10.1186/1471-230X-11-118
Celiac.com 06/08/2011 - A team of researchers recently set out to determine whether delaying gluten introduction in infants with genetic risk for islet autoimmunity is feasible, safe, and able to reduce the risk of type 1 diabetes–associated islet autoimmunity. The research team included Sandra Hummel, PHD, Maren Pflüger, PHD, Michael Hummel, MD, Ezio Bonifacio, PHD, and Anette-G. Ziegler, MD. They are variously affiliated with the Institute for Diabetes Research, Helmholtz Zentrum München, Forschergruppe Diabetes der Technischen Universität München, the Institut für Diabetesforschung der Forschergruppe Diabetes e.V. am Helmholtz Zentrum München, Munich, Germany, and the Deutsche Forschungsgemeinschaft Center for Regenerative Therapies Dresden, Technische Universität Dresden, Germany. For the study, the team recruited a total of 150 infants with a first-degree family history of type 1 diabetes and a risk HLA genotype. They then randomly assigned each infant to a first gluten exposure at age 6 months (control group) or 12 months (late-exposure group). The team followed-up on each infant at three month-intervals until the age of 3 years, and then yearly thereafter. The team tested for growth and autoantibodies to transglutaminase C [TGCAs]), islet autoantibodies to insulin, GAD, insulinoma-associated protein 2, and type 1 diabetes. A total of 70% of families reported following the dietary-intervention protocol. For the first three years, children in the control and late-exposure groups showed similar weight and height, along with similar probability of developing TGCAs (14 vs. 4%; P = 0.1). A total of eleven children in the control group and 13 children in the late-exposure group developed islet autoantibodies (3-year risk: 12 vs. 13%; P = 0.6). Seven children developed diabetes, including four in the late-exposure group. The team saw no significant differences when analyzing children as per protocol on the basis of the first reported reported gluten exposures for the children. From the data, the team concluded that delaying gluten exposure until the age of 12 months is safe, but does not significantly reduce the likelihood of islet autoimmunity in genetically at-risk children. Source: DiabetesCare.com