February 11, 2004
Question from Fairfield, Ohio, USA:
My son is 4 years old and has type 1 diabetes. He was diagnosed a month before his third birthday. His paternal grandfather was diagnosed with celiac disease a year prior. Since both are autoimmune diseases and hereditary, what are my son's chances of developing celiac? It is my understanding that celiac is present in 1 out of 22 people who has a close relative with celiac and 1 out of 20 people with type 1 develop celiac disease. Since both are in the our family, how much does this increase his risk? He complains of belly aches often and was tested 6 months ago and the results were negative.
Your statistics are right on. We think celiac disease is occurring in around 5-8% of the kids with type 1 diabetes. Data for adults with type 1 are more difficult to come by in the USA. Nobody can answer the exact risk for one individual but having both disorders already in the family suggests that you have the gene running in your family. There are no definite rules for checking but we routinely screen with a transglutaminase antibody annually. That seems to be the general trend around the world (US, Canada, Europe) now that the screening antibody technique is more standardized. Some folks are also screening for celiac with other autoimmune disorders such as thyroid disease. Some would include Turner Syndrome and Down Syndrome as well.