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May 28, 2009

Behavior, Celiac

Question from Waukesha, Wisconsin, USA:

Our daughter was diagnosed in 2006. She has had a lot of unexplained highs and lows. We found her sneaking anything she could get find and eating it. She was also suffering from constipation problems, a problem that still persists. She was checked multiple times for celiac but it has come back negative. The doctors took her off of dairy products, but that doesn't seem to help either. Is there something else for which we should be checking?

Answer:

If you found her sneaking food once, this may be occurring multiple other times. This needs to be explored and addressed. Omitting insulin is also quite common under such circumstances and sometimes even taking extra insulin. All this obviously causes disrupted blood glucose control and often points to an underlying psychological issue that needs to be addressed. You should go back to your diabetes team for further specific advice. Parents resuming more control of food and monitoring, logbook analysis, etc., often solves such problems in pre-teens and teenagers.

The constipation could be gluten sensitivity but not classical celiac disease. It might be worthwhile to stop completely all gluten/wheat/gliadin for three or four weeks and see if the problem resolves even if the antibody tests were negative. Some of our patients have this diagnosis with negative transglutaminase antibodies, but positive anti-gliadin antibodies, and respond quite well to strict gluten free feeding.

SB