Search the Community

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 02/22/2017 - Type 1 diabetes mellitus (T1DM) and celiac disease (celiac disease) are autoimmune diseases that share similar genetic patterns. T1DM treatment is based on diet, physical activity and insulin therapy, whereas celiac disease treatment is based on a gluten-free diet. A research team recently set out to evaluate the quality of life (QoL) of individuals with the association of T1DM and celiac disease, to characterize their nutritional status and to compare it with those with only one disease and to healthier control subjects. The research team included JG Nunes-Silva, VS Nunes, RP Schwartz, S1 Mlss Trecco, D Evazian, ML Correa-Giannella, M Nery, and MS Queiroz. The are variously affiliated with the Nutrition and Dietetics Division, Central Institute of Clinics Hospital, the Lipids Laboratory (LIM-10), Endocrinology and Metabolism Division of Hospital das Clinicas, Faculty of Medical Sciences, the Radiology Institute of Clinics Hospital, the Cellular and Molecular Endocrinology Laboratory (LIM-18), and the Endocrinology Division, Internal Medicine Department, all at the University of São Paulo Medical School, São Paulo, Brazil. The researchers evaluated sixty patients controlled by sex, age and body mass index (BMI). Patients were further divided into the following groups based on previous diagnosis: DMCD group (T1DM and celiac disease); DM group (T1DM); celiac disease group (celiac disease); or HC (healthy control subjects). They used the SF-36 questionnaire to assess psychological well-being, and compared the results with glycemic control, presence of complications related to diabetes, and adhesion to gluten-free diet (GFD). Using BMI, waist circumference, bio-impedance, general laboratory tests and whole-body densitometry, they determined nutritional status and body mass composition. Both the DMCD and DM groups had similar times of diagnosis, but the duration of celiac disease was significantly higher in the celiac disease group compared with DMCD. The SF-36 analysis revealed statistically significant differences between DM and HC groups in two domains: general health (P=0.042) and energy/vitality (P=0.012). QoL was also correlated with compliance to a GFD, and scores were similar in both groups: DMCD and celiac disease. Forty percent of individuals in the celiac disease group had visceral fat area above 100 cm2, compared with just 20% in the other groups. So, are people with both Type 1 diabetes and celiac disease automatically doomed to worse health? It seems not. To be sure, they are generally less healthy than control subjects, but the study found that the DMCD group had similar scores to DM, celiac disease and HC on QoL, as well as on their nutritional status and bone metabolism. The researchers conclude from this that the association of T1DM and celiac disease did not deteriorate the health status of the individuals with both Type 1 diabetes and celiac disease. So, it seems that having both Type 1 diabetes and celiac disease dose not automatically mean having worse health, nutrition and well-being. Source: Nutr Diabetes. 2017 Jan 9;7(1):e239. doi: 10.1038/nutd.2016.43.

Celiac.com 07/22/2011 - Many reports indicate a hypercoagulative state in diabetes mellitus as result of endothelial damage. Numerous researchers have reported a strong association between type 1 diabetes mellitus (DM1) and celiac disease. Clinical data indicate that vascular dysfunction can result from a cascade of biochemical events triggered by a metabolic malfunction. The net result changes the cells that line the interior surface of the blood vessels; from a surface called a thrombo-resistant surface to one called a thrombo-genic surface. A research team recently set out to determine whether celiac disease in a group of DM1 patients is connected with a different expression of certain hemostatic factors, and with a different manifestation and/or progression of microvascular complications of DM1, as compared to patients with diabetes alone. For the study, the team enrolled ninety-four adult patients with DM1, who they then screened for celiac disease. They found anti-endomysial antibodies (EMA) in 13 of 94 DM1 patients (13.8%). The team then confirmed celiac disease diagnosis by histology and organ culture. The mean age and duration of DM1 of patients also affected by celiac disease were similar to those patients with diabetes alone, but the groups showed very different parameters for metabolic control and hemo-coagulation. In DM1 patients with celiac disease those parameters include: Signiï¬cantly lower concentrations of glycosylated hemoglobin (HbA1c) (P.05), cholesterol (P.001), triglycerides (P.001), factor VII antigen (FVII:ag) (P.005), factor VII coagulant activity (FVII:c) (P.05), and prothrombin degradation fragments (F1+2) (P.001). Higher values of activated C protein (APC) (.001). DM1 patients with celiac disease showed no retinal abnormalities and no signs of renal damage.The results suggest a potential protective role of celiac disease in the pro-thrombotic state of DM1. Source: Acta Diabetol. DOI 10.1007/s00592-011-0301-1

Celiac.com 12/25/2012 - The connection between celiac disease and type 1 diabetes mellitus is well known. Up to now, very little has been reported about rates of celiac disease in children and adults with type 1 diabetes in Sicily. A team of researchers recently set out to assess the prevalence of celiac disease in patients with type 1 diabetes mellitus who come from a specific region of western Sicily and to assess the clinical features of these patients. The research team included D. Greco, M. Pisciotta, F. Gambina, and F. Maggio of the Division of Diabetology at Paolo Borsellino Hospital in Marsala, Italy. For their study, they analyzed data from 492 consecutive patients with type 1 diabetes mellitus who were referred over a five year period. They found that, of the 492 patients with type 1 diabetes, 14 females and eight males (a total of 4.5%) suffered from celiac disease. The patients averaged thirteen years of age at the time of diabetes onset. The team found that patients were diagnoses with celiac disease either at about the same time as diabetes, or afterward. They found that eight patients (36%) had coexisting autoimmune thyroiditis. Their data show that, within this Sicilian population, the association between celiac disease and type 1 diabetes is common, though at lower rates than in other studies of the Italian population. They also found high rates of autoimmune thyroiditis in these patients. They also noted that celiac disease diagnosis often followed onset of type 1 diabetes, especially in females whose diabetes began at an early age. They conclude that this finding warrants an active search for the celiac disease for many years after the onset of diabetes. Source: Endocrine. 2012 Jun 16.

Celiac.com 08/20/2012 - People with Type 1 Diabetes (T1D) suffer from celiac disease at rates ranging from 4.4 to 11.1%, compared with rates of 0.5% for the general population. The reason for this connection is due at least in part to the fact that the HLA genotypes DR3-DQ2 and DR4-DQ8 are strongly associated with T1D, while DR3-DQ2 is associated with celiac disease. To get a better sense of the issue, a research team recently assessed celiac disease in type 1 diabetes mellitus. The research team included Maria Erminia Camarca, Enza Mozzillo, Rosa Nugnes, Eugenio Zito, Mariateresa Falco, Valentina Fattorusso, Sara Mobilia, Pietro Buono, Giuliana Valerio, Riccardo Troncone, and Adriana Franzese. The are variously affiliated with the Department of Paediatrics, "Federico II" University, the School of Movement Sciences (DiSIST) at Parthenope University, and the Department of Cellular and Molecular Pathology "L. Califano", "Federico II" University, all in Naples, Italy. People with T1D rarely show classical severe symptoms of celiac disease. Usually, they have few or mild symptoms of celiac disease, or show no symptoms at all (silent celiac disease). In fact for T1D patients, diagnosis of celiac disease is usually done by blood screening. The effects of gluten-free diet (GFD) on the growth and T1D metabolic control in celiac disease/T1D patient are controversial. There is some debate about whether gluten-free foods have a higher glycemic index compared with to gluten-containing foods; and also about whether gluten-free foods might be be lower in fiber and higher in fat. Adherence to a gluten-free diet by children with celiac disease-T1D has generally been reported at below 50%, compared with about 73% for those with celiac disease alone. Failure to follow a gluten-free diet is even more common among asymptomatic patients. The more severe problems of gluten-free diet adherence usually occur during adolescence when non-compliant subjects report the lowest quality of life. The researchers suggest providing psychological and educational support for these patients. Source: Ital J Pediatr. 2012; 38: 10. doi: 10.1186/1824-7288-38-10