My daughter is seven years old and she is diabetic. Now, there is a new problem: the last test of antibodies antiendomyseal IgG is positive 79 units with the ELISA method. Her doctor says that we must wait a little period of time (3 months) and repeat it. In case it were positive again, we must practice a biopsy in order to know if she has the celiac syndrome. How much possibility does she have of being celiac? The antibodies antigliadine IGA are negative. How are we going to live in this case? Is there any diet for both diabetes and celiac?

Celiac disease is an another autoimmune condition which can be present in up to 10% of children with Type�1A diabetes. The most discriminating test nowadays is for antitransglutaminase antibodies rather that for antoendomyseal antibodies. In any case, different centers respond differently to a positive antibody test. The orthodox approach, as suggested by your daughter’s doctor, is to confirm the diagnosis by doing an intestinal biopsy and then to start treatment with a gluten (wheat) free diet. In some places where there has been good correspondence between the biopsy and the antibody test, the former is now omitted. Treatment however is important irrespective of the presence or absence of symptoms because failure to treat seems to increase the chances of getting a lymphoma of the bowel in later years.

It is certainly possible to devise a wheat free diet that is also suitable for a diabetic; but you will need the help of an experienced dietitian. One book that would be easy to obtain would be Gluten free Cookery: The Complete Guide for Gluten Free and Wheat Free Diets by Peter Thomson, obtainable from www.amazon.com. Your dietitian might have a better suggestion, though, for a 7 year old.

DOB