November 3, 2004
Celiac, Honeymoon
Question from Youngstown, Ohio, USA:
I’m looking for some advance information before my daughter’s next doctor visit with her endocrinologist. My daughter is now 12 years old, weighs 104 pounds, and was diagnosed with type 1 diabetes in March of 2003. She has had very good control with A1cs between 4.9 and 5.9 since that time. She takes five and a half units of Lantus a day and one unit of Humalog for each 15 grams of carbohydrates she eats (an average of 250 carbohydrate grams per day). Can we assume she is still in the honeymoon period? If so, how long might it continue to last with good control?
Also, she was recently tested for celiac antibodies and the test came back positive, showing a “slight” reaction to wheat. The doctor recommended we limit her wheat intake until the next test in January. If she reduces her wheat intake now, could it help to prevent the actual development of celiac sometime in the future? Are there any figures that state what the chances of developing celiac are if one tests positive for the antibodies, but negative for celiac itself?
Answer:
It is rather a tall order that your daughter would still be in honeymoon after 18 months, especially at a pubertal age.
I am concerned at the advice you have received about celiac disease. It is wrong to manipulate the diet prior to a formal diagnosis which can only be made with a small bowel biopsy, a simple outpatient procedure. On the contrary, she should continue on her normal diet and, if the next test is positive, then a biopsy is mandatory. Prior to this, if she develops symptoms of bowel upset or bloating, then you should take her straight back to her endocrinologist. To answer your specific question – no, you will not prevent celiac disease by altering her diet.
KJR
