Both my four year son and I have diabetes, and my nine year old daughter tested positive for celiac disease but her biopsy was negative. I know that in people with diabetes, 5-8% of people can develop celiac disease. What are the chances of developing diabetes if you tested positive for celiac disease?

Assuming that you yourself have type 1A (autoimmune) diabetes, then your daughter’s chance of developing the same problem is a little less than 1:20. It’s difficult though to refine this further, but what it does suggest is that all of you in fact have the Autoimmune Polyglandular Syndrome Type II in which more than one autoimmune condition can be grouped together, the most common being diabetes, hypothyroidism, and celiac disease. This suggests that it might be wise for all of you to have a TSH test for hypothyroidism and for your son to have an anti glutamyltranferase test for celiac disease even if he is asymptomatic.

Coming back to being more exact about the chances of your daughter getting diabetes: HLA antigen typing would help, but it is expensive, and it would be more useful to find out if any of the standard antibody tests for diabetes are now positive, those are GAD, ICA 512/IA 2 and anti insulin. Finally, I assume that with a negative biopsy that your daughter is not on a gluten-free diet. However, you should know and discuss with your diabetes team the very equivocal evidence that going on a gluten-free diet may defer insulin dependence.

DOB