My eight year old daughter was diagnosed with type�1 diabetes 18 months ago and since then, she has been in very good control and recently went on the insulin pump. She has tested negative for celiac disease, and it does not run in our family. However, a friend’s 22 year old daughter (type 1 for 12 years ) was recently diagnosed with celiac disease, and I am wondering if reducing wheat/gluten in my daughters diet now would help reduce the likelihood of her developing it. The meal plan for a child with diabetes (like most kids) diet has a lot of bread and pasta carbs in it. Any studies on this?

There is no evidence that avoiding gluten would prevent celiac disease A gluten free meal plan is very difficult to follow, so without any scientific evidence to suggest a benefit in avoiding celiac disease by avoiding gluten products, there is no reason to suggest this therapeutically for those with diabetes.

People with type�1 diabetes seem to have about a 3-10% risk of positive antibodies (transglutaminase is most sensitive and specific, endomysial antibody next best and anti-gliadin least specific), and the risk does not seem to be only at diagnosis of type 1 diabetes, but seems continuous. Exactly how long such screening should take place is not known. Whether or not to screen all type 1 patients is also not known, but more and more is being recommended. We have recently changed our recommendation and now are screening all our type 1 patients with transglutaminase antibody – and seem to be finding the expected 5% positive this past year. All screened positive with the transglutaminase antibody in our population have had negative x-ray studies and positive biopsies — so far.

SB