My four year old, who has had type 1 diabetes for a year and a half, was just recently also diagnosed with celiac disease. While there is quite a bit of information on each topic individually, I cannot seem to locate much on the topic that helps people who have both conditions. Any ideas where this information may exist?

This is a difficult combination and one, unfortunately, which seems to be happening more often. Since you indicate that you can find information on individual topics, I will not review those with you.

As you may know celiac disease is also thought to be related to an underlying autoimmune process affecting the intestines (and their ability to digest certain grains, especially wheat). Type�1 diabetes is another autoimmune process, that affects the insulin producing beta cells of the pancreas. The common thread is the autoimmune nature of the diseases, that is, the immune system “attacking self.” Other related conditions include some thyroid diseases (near 20% of people with type 1 have thyroid disease), adrenal gland problems, skin pigment losses (vitiligo), vitamin B12 deficiency, systemic lupus, and rheumatoid arthritis. Other conditions can affect calcium balance, parathyroid hormone levels, and can be associated with increased fungal skin infections. These more worrisome combinations are referred to as Autoimmune Polyglandular Syndrome.

Your child’s diabetes team should be able to guide you and to tell you when they might consider screening for these others. In my mind, having two of them does put your child in a higher risk category.

DS

[Editor’s comment: See a previous question on this topic. Also, our Celiac / Type 1 Mailing List provides support for families with both type 1 diabetes and celiac disease.

SS]