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October 21, 2006

Celiac, Research: Cure

Question from Indonesia:

I read some articles about celiac disease and how it also could cause the type 1 diabetes (by viral infection). If someone were already diagnosed with type 1 diabetes and then later on he's also diagnosed with celiac disease, could the pancreas work normal again if this person were to eat gluten-free food forever? If celiac disease were the cause of type 1 diabetes, would there be any cure available, besides taking insulin and eating no food that contains gluten?

Answer:

It is not likely that celiac disease causes type 1 diabetes. But, both are autoimmune disorders. With type 1 diabetes, the beta cells of the pancreas are attacked, an inflammation occurs (called islitis) and then the beta cells are destroyed. In celiac disease, we actually know what sets up the inflammatory process, but this time it is the intestinal lining. Wheat/gluten is the culprit and, therefore, avoiding wheat allows the gut to heal itself. About 6 to 10% of type 1 patients also have celiac disease, often asymptomatic. However, the reverse does not seem to be true. So, there is almost no type 1 diabetes in those who start with celiac disease. We do not understand why. There is much active research around the world trying to answer such questions.

Most recommendations suggest screening type 1 diabetes patients not only for celiac disease with transglutaminase antibody levels periodically, but also for thyroid disease as well. Other populations at high risk for otherwise asymptomatic celiac disease include those with Down Syndrome, those with Turner syndrome, and, perhaps, also those with Hashimoto’s thyroiditis as well.

SB