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September 22, 2007

Diagnosis and Symptoms

Question from Brisbane, Australia:

I am almost 21 years old and was sent to a dietitian who is also a diabetes specialist. After speaking with me for a few minutes, she decided that I seem to be wheat intolerant (despite having no real problems with wheat) and am going to have type 1 diabetes within 24 months as I had a grandparent with it. She took my blood sugar and it was 4.9 mmol/L [88 mg/dl]. It was 2 p.m. and I had not yet eaten that day. She said that I must have excellent insulin resistance to produce that reading, but the type 1 diabetes is still coming and she can help me stop its onset. I asked my general practitioner about what she said and he told me not to worry about it, while my fathers doctor said that I am indeed a ticking type 1 diabetes time bomb and should be worried. I am really unsure what to believe and am asking for your opinion.


I don’t have enough information to really answer your questions except the ability to predict who will develop diabetes is really quite insensitive and unreliable, unless there have been genetic testing and antibody testing. Just having a nonspecific wheat allergy does not cause diabetes, however, so you may have misunderstood what they said to you or they may have said it far too forcibly. There is some genetic link with celiac disease and type 1 diabetes just as there are other autoimmune endocrinopathies so linked i.e., thyroid problems, pernicious anemia, Addison’s disease. There are also some studies looking at what triggers a person who is genetically susceptible to develop type 1 autoimmune diabetes and wheat/gluten exposure and some studies have been supportive.

I would suggest talking to this dietitian once again with these same questions that you now pose and get more specific answers and details of why they have made this recommendation. Ask to see the research articles upon which their proposal is based and then decide together if this makes sense for you when you analyze your own laboratory work with what they are worried about, proposing, etc.