August 19, 2000
Other Illnesses
Question from Italy:
I noticed in a recent poll about celiac disease that 85% responded that they are unfamiliar with this disease or have never been tested. Our son has this condition, and if he eats wheat we find his blood sugar values swing wildly. Since this disease can often be flagged with a simple blood test, shouldn’t it be recommended for every person with diabetes, especially in light of a recent American Medical Association study that showed the incidence of celiac may be much higher (one in 33 as opposed to one in 5000)? In fact, because celiac is associated with so many other diseases (Crohn’s, lupus, rheumatoid arthritis, intestinal tumors, anemia, etc.), several which are common in diabetic children, shouldn’t everyone be tested for this problem?
I read on the American Academy of Family Practice website the following statement by Anne D. Walling, MD: “Sometimes our understanding of specific conditions changes dramatically. Celiac disease is now considered a common, underdiagnosed condition that affects adults as well as children…. In the future, will gluten rival cholesterol as the principal nutritional public enemy.”
Answer:
As you already know, Type�1A (autoimmune) diabetes is quite often associated with other autoimmune conditions. When this occurs it is sometimes called the Autoimmune Polyglandular Syndrome. Diabetes is not always present; but when it is by far the commonest associated condition is hypothyroidism and after that, celiac disease and then a form of adrenal insufficiency. Hypothyroidism is usually tested for routinely at intervals especially around growth spurts and in many centers the other two conditions are indeed routinely screened for. There is quite a long list of other autoimmune conditions that can be; but only occasionally are associated with this syndrome.
Recognition of the association between diabetes and the celiac syndrome has been a relatively recent occurrence and as the knowledge of the relationship continues to grow amongst physicians, people with Type 1 diabetes and those who care for them the demand for the test and the laboratory support for it will grow accordingly. However I do not think that gluten sensitivity will ever have quite the pervasive role in public health that cholesterol does.
DOB
