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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.

Celiac.com 12/29/2015 - I discussed the possibility of a Low Glycemic Paleo Diet as an entertaining idea as a beneficial diet for celiac in the last issue, Winter 2015. In closing, I stated I would reveal more about this topic in the coming issue. So, let's dive in and open our eyes to some facts and even some revealing possibilities that may very well help improve our health and quality of life. As a celiac myself, (2 of my three kids have celiac disease and my grandfather died from undiagnosed celiac disease) I was more than happy to follow the gluten-free diet diligently once finally diagnosed after many years of distress, bone loss, declining health not to mention non-stop bone aches, bowel inconsistency and severe lack of muscle tone. I will spare you further details but there was no doubt a major beneficial change that occurred once I eliminated all gluten from sources of wheat, rye and barley and all its "relatives" or any possible cross contamination. Eventually I was thrilled to be able to eat baked good substitutes that did not hurt my belly, cause my joints and bones to ache and were absolutely delicious and healthy, as they were gluten-free! Soon after I became an active advocate (and for many years) I was thrilled to be able to speak broadly to help raise awareness about celiac disease and the NEED for the gluten-free diet. I was also soon working closely with many gluten-free companies (as a tester, consultant and promoter) becoming blind to the fact that the boxes that were arriving to my door by the truckload were all desserts, loaded with carbohydrates and sugars. At the time I wrote and spoke often (in interviews and on radio) about Type 2 diabetes and celiac disease but never put two and two together. If lifestyle and diet change can address Type 2 permanently, what were these diet changes that were so effective? Also, even more to the point, why was Type 2 diabetes so common as a diagnosis after being diagnosed with celiac disease and going on the gluten-free diet? Research suggests an association between Type 1 diabetes and celiac disease, but there does not appear to be a link between celiac disease and type 2 diabetes. Type 2 is not an autoimmune disorder and doesn't share genes with celiac disease. According to the Celiac Sprue Association, individuals can be genetically predisposed to Type 2 diabetes, but those genes don't increase the risk of celiac disease. Let's look at the immense increased ingestion of glucose, sugars and carbohydrates and fiber while one is on the gluten-free diet by indulging in baked goods, desserts and grains! Gluten-free foods and grains are typically made with rice starch (or brown rice starch), tapioca starch, cornstarch and potato starch. All of which have virtually no fiber. Hence straight into the blood stream spiking the blood sugar bite after bite and quickly. The latest attempt is many companies and cooks trying to improve nutrients by baking with higher fiber gluten-free grains with higher nutrient value. Such as teff, millet, buckwheat etc. These are all still VERY HIGH in carbohydrates and very little fiber to slow the glycemic entrance into the blood system, still resulting in spiking the blood sugar rapidly. I must mention that most people do not just eat 2-3 bites of millet or a ¼ cup of cooked buckwheat. This would be easier on the body, but it seldom occurs. Carbohydrates are a type of nutrient in foods and some feel we need this to survive physically and some MD's are saying we need far less than we ever thought. The three basic forms are sugars, starches and fiber. Different types of carbohydrates have properties that affect how quickly your body digests them and how quickly glucose enters your bloodstream. When we eat or drink anything with carbs, the body breaks down the sugars and starches into a type of sugar called glucose. Glucose is the main source of energy for cells in the body. Fiber passes through your body undigested. The unused glucose for energy is quickly taken out of the blood stream by the insulin and "stocked" away in the cells for future energy as fat. It is the body's amazing way of survival. To elaborate a bit more, the two main hormones from the pancreas help regulate glucose in the bloodstream. Insulin moves glucose from the blood into the cells. Glucagon helps release glucose stored in your liver when the blood sugar (blood glucose) level is low. I suggest to anyone to take a look at the nutritional value on all packages and foods and get familiar with the amount of carbohydrates you are ingesting through your meals, snack and drinks. Get familiar with the carbohydrate, sugar and fiber levels in the food you buy and have in your home. Getting educated is the first step to learning and then you can make changes to suit your health and body goals. A healthy paleo or gluten-free diet is a low glycemic one at the very least. A low glycemic diet can improve all manner of current health situations. By statistics and more than abundant research, it will deter diseases quiet commonly associated with a high glycemic diet. We will expand on this topic next time. At this point I would like to refer you to some highly respected professionals and allow you to do further research and come to your own conclusions. Please look further into DrPerlmutter.com, Mercola.com, WheatBellyBlog.com, BulletProofExec.com, ChrisKresser.com, MarksDailyApple.com. As always, wishing you the best in your life and health!

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.