Ellen
04-30-2008, 11:58 AM
Celiac Disease: An Important Comorbibity Associated With Type 1 Diabetes Elizabeth A. Fasy and Guillermo Umpierrez
Clinical Diabetes 2008 26: 85-87. [Extract] (http://clinical.diabetesjournals.org/cgi/content/extract/26/2/85) [Full Text] (http://clinical.diabetesjournals.org/cgi/content/full/26/2/85) [PDF] (http://clinical.diabetesjournals.org/cgi/reprint/26/2/85)
aklap
04-30-2008, 09:29 PM
Great article Ellen, thanks for sharing!
Because of the availability of serological screening, more cases of mild celiac disease are now being diagnosed. In one study estimating the prevalence of celiac disease in adults with type 1 diabetes, patients who were screened and found to have positive antibodies and positive findings on small bowel biopsy typically had no symptoms.2 Patients often have nonspecific complaints, such as fatigue. They may have borderline iron deficiency, elevations in aminotransferases, or no symptoms at all. Once patients are placed on a gluten-free diet, they report objective and subjective improvement in well-being regardless of whether they recognized symptoms before diagnosis.
The prevalence rates of celiac disease in children with type 1 diabetes are estimated to be between 1.7 and 12%. Screening studies have shown the prevalence among adults with type 1 diabetes to be similar, between 1.3 and 6.4%, which is 10 times the prevalence in the general population.
Of children with type 1 diabetes, 16% have been shown to have positive antibodies, and of these, 6.2% had definitive biopsy changes consistent for celiac disease despite being asymptomatic.
The 2008 American Diabetes Association clinical practice recommendations state that antibody screening should be performed in patients with type 1 diabetes with suggestive symptomatology, such as iron deficiency anemia, weight loss, or unexplained fatigue.
Hey - they just got done saying that it can present with no symptoms at all. However, they recommend to test T1D patients with suggestive symptomatology? Am I missing something? Shouldn't they be testing all of them to catch the asymptomatic ones too?