My daughter was diagnosed with type 1 at age 5.5. She is now 12.5. She also has Hashimoto’s, intermittent slight microalbuminaria, clinically low vitamin D, gastroparesis, migraines and the typical symptoms of celiac (however, she has been negative on blood tests and her endoscopy only showed areas of white plaque in her esophagus, no flattening of the villi). Aside from the type 1 and associated medical issues, she is very healthy and active. She is of half-Finnish descent and we have no known history of type 1 on either side of our family. She will be in Finland this summer visiting family, Do you know of any studies or other research happening in Helsinki or elsewhere in Finland that may be beneficial to her or a medical team? We understand Finns have one of the highest rates of type 1 in the world.

It sounds like she is getting quite reasonable care and surveillance. The Finnish medical system and their research is quite good but there are no specific studies which would pertain to your questions. In Helsinki, the pediatric diabetes research is spearheaded by Professor Mikael Knip and his colleagues at the Children’s Hospital. I am not sure exactly what research you had in mind.

The only question that I have related to your medical summary would be whether a trial eliminating all wheat/gluten products completely would be beneficial. We have many such patients who report feeling a lot better, headaches gone, more energy, better bowel movements, etc. with positive celiac antibodies but negative biopsies. So, despite our gastrointestinal colleagues indicating that no such treatment is needed, we usually suggest trying it for three months and then making a decision based on how one feels and functions rather than just the tests. The antibody levels, if one truly is gluten free, usually normalize and the symptoms usually come back when gluten is reintroduced, so whether this is true celiac disease or some variant is difficult to know for certain but if our patients feel better and function better – and are wiling to stay gluten free – then this seems worthwhile.

SB