Celiac disease and insulin-dependent diabetes mellitus

Abstract

We screened for celiac disease, by means of IgA class anti-endomysium antibodies (EmA), 383 consecutive adults with insulin-dependent diabetes mellitus (IDDM). Two control populations entered the study as well: 151 adults with biopsy proven celiac disease, as true positives; and 520 controls (healthy and diseased) as true negatives. IgA-EmA positivity was found in 145 of 151 (96%) celiac disease patients but in none of the controls (100% specificity). EmA were positive in 12 of 383 (3.13%) IDDM patients: 10 of these positives underwent intestinal biopsy, which showed either partial or total villous atrophy. Only one patient presented with gastrointestinal complaints, but severe iron deficiency was found in all. The IDDM celiac patients were started on a gluten-free diet: four refused both the diet and the follow-up protocol. Approximately one year after gluten withdrawal no significant change in the degree of diabetes control was observed, while an increased requirement for insulin was observed in three of four patients who strictly complied with the diet. The prevalence of biopsy-proven celiac disease among adult IDDM patients (1:38), eight times higher than that recently estimated for the general Italian population and the absence, except in one case, of gastrointestinal symptoms emphasizes the benefit of screening programs on populations at risk.

A Longitudinal Study of the Effects of a Gluten-Free Diet on Glycemic Control and Weight Gain in Subjects With Type 1 Diabetes and Celiac Disease

“…Others have previously shown no difference in growth parameters regardless of dietary compliance (20). Within case subjects, the start of a GFD resulted in further significant improvement in mean HbA 1c levels compared with pre-GFD, confirming findings of some studies (24,27) but not others (13,14,19,25). Furthermore, mean HbA 1c levels were also lower when compared with control subjects.…”

“…Some report short stature with no differences in weight (4,5,11,16), whereas others have shown no differences in height or weight (15)(16)(17)19,25). During the same period, HbA 1c levels were lower in case subjects despite no difference in Cpeptide levels.…”

Coeliac disease in children and adolescents with IDDM: clinical characteristics and response to gluten-free diet

“…Similar observations have were on a gluten free diet, and who were re-biopsied, demonstrated a resolution of their abnormal small bowel been reported in other studies in Type 1 diabetes, 10,12 although others have reported a high frequency of mucosal appearances, confirming the diagnosis and the success of treatment. haematological and biochemical abnormalities including iron deficiency anaemia, low serum folate and ferritin All our subjects experienced difficulties adjusting to the gluten free diet and all required regular dietetic levels and hypertransaminaemia, 14,25,26 in association with the coeliac disease. It is known that a wide spectrum support and advice in the early stages.…”

Celiac Disease-Associated Autoimmune Endocrinopathies

“…Autoimmune polyglandular syndrome is a rare endocrine disorder comprising a combination of at least two of the following autoimmune endocrine disorders: Addison's disease, autoimmune thyroid diseases, hypoparathyroidism, type I diabetes, or primary gonadal failure (20,42,46,90). In addition, nonendocrine diseases that have been described in autoimmune polyglandular syndrome include mucocutaneous candidiasis, vitiligo, alopecia, pernicious anemia, autoimmune hepatitis, primary biliary cirrhosis, and intestinal malabsorption.…”