October 12, 2009
Genetics and Heredity, Other Illnesses
Question from North Carolina, USA:
I have had type 1 diabetes for 15 years; my twin has had it for 12. We are 27 years old. I was recently diagnosed with gastroparesis and she was just diagnosed with celiac disease. Since we are identical twins, are we each doomed to get the other’s disease, such as me getting celiac and her getting gastroparesis? We both maintain A1cs under 6.3. I was told the gastroparesis was a form of diabetic neuropathy but not from poor control, just something some diabetics get and she was told that celiac was very common among diabetics. Also, are there any trials out there dealing with either of these diseases?
I would make sure that you are screened for celiac disease. This can be done by a routine blood test that your physician can order. If it were positive, your doctor would probably have you see a gastrointestinal specialist who may want to do a small bowel biopsy through the endoscope to confirm the diagnosis. It is very likely that if your identical sister has this, you might, too. The treatment, as you may know, is to eat a gluten-free diet. This diet is used to decrease symptoms and it actually improves the appearance of the small bowel with follow-up biopsy. If you are not symptomatic at present, you may not notice any change in symptoms if you go to the diet. It is always good to know, however.
With regard to the gastroparesis, that is a more difficult question. Diabetes-related complications are usually a function of duration of disease and intensity of glucose exposure. If you have had good control for a long time, that is as much as you can do to protect yourself. Since this falls into the category of environment, this might be one area where identical twins might have different results, as control for each could be different. However, you say that you have both been well controlled. It remains to be seen. It would be interesting to know if treatment of her celiac disease made her gastroparesis symptoms go away.
[Editor’s comment: See Clinical Trials.gov for information on current trials for which you might be eligible.