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Thread: Remission without insulin therapy on gluten-free diet in a 6-year old boy with type 1 diabetes mellitus.

  1. #1

    Default Remission without insulin therapy on gluten-free diet in a 6-year old boy with type 1 diabetes mellitus.

    A 5-year and 10-month old boy was diagnosed with classical type 1 diabetes mellitus (T1DM) without celiac disease. He started on a gluten-free diet after 2-3 week without need of insulin treatment. At the initiation of gluten-free diet, HbA1c was 7.8% and was stabilised at 5.8%-6.0% without insulin therapy. Fasting blood glucose was maintained at 4.0-5.0 mmol/l. At 16 months after diagnosis the fasting blood glucose was 4.1 mmol/l and after 20 months he is still without daily insulin therapy. There was no alteration in glutamic acid decarboxylase positivity. The gluten-free diet was safe and without side effects. The authors propose that the gluten-free diet has prolonged remission in this patient with T1DM and that further trials are indicated
    Link

    And while on the subject Dietary gluten and type 1 diabetes

  2. #2

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    Although this is interesting, remember that it is a "case study". It reports on something very unusual that happened to exactly one person.

    Joshua Levy

  3. #3

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    Is it plausible that a newly diagnosed T1D, when on a restricted, low or zero-carb diet, during the honeymoon could go without insulin and maintain a low A1c?
    Stay at home Dad to son, 14.
    Diagnosed: 02/2006
    OmniPod: 09/2007, Novolog
    Dexcom Seven Plus: 02/2010 Dexcom G4: 01/2013

    Throughout history

    Every mystery
    EVER solved has turned out to be ...
    Not Magic. - Tim Minchin

    Hydrogen, given sufficient time, turns into people. - The Meaning of Life

  4. #4

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    Possible if they were diagnosed very early through Trial net testing, or without any major symptoms or DKA, OR they would have needed insulin for those first 3 weeks.
    Jane Mum of Rachel, 13, dx'd @11 months and Anna, 18, dx'd @ 17 .

    Keep Calm and Treat the Number

  5. #5

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    I read another summary that stated he was on insulin for 5 weeks. I'll have to find the link later.

    ETA: This is the link. Does anyone here have access to the whole paper?

    BTW, I only focused on the summary of the study, so I don't know what else that blog is talking about.
    Last edited by danismom79; 10-10-2012 at 07:03 AM.

  6. #6

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    It implied he was on insulin the first 3 weeks.
    Stay at home Dad to son, 14.
    Diagnosed: 02/2006
    OmniPod: 09/2007, Novolog
    Dexcom Seven Plus: 02/2010 Dexcom G4: 01/2013

    Throughout history

    Every mystery
    EVER solved has turned out to be ...
    Not Magic. - Tim Minchin

    Hydrogen, given sufficient time, turns into people. - The Meaning of Life

  7. #7

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    Quote Originally Posted by swellman View Post
    Is it plausible that a newly diagnosed T1D, when on a restricted, low or zero-carb diet, during the honeymoon could go without insulin and maintain a low A1c?
    My guess is "yes" for zero-carb or very low carb diet. That's what was done prior to 1920 (discovery of insulin). People could live for a few months or years like that.

    However, for this case, specifically, it said the person was on a no-gluten diet, which still includes many carbs.

    Joshua Levy

  8. #8

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    I've heared of a couple of stories that kids didn't use insulin by going in a grain-free paleo style diet. I am sure that proccessed food and gluten doesn't help your cells. However all those cases after a couple of months go back to insulin. I was following a blog of a parent that managed to keep her daughter off insulin for 8 months with a diet including carbs but not procecced food, gluten or dairy. I don't know whats more dificult to do. I chose insulin and a less restrictive diet.
    Katerina mom of Paul 14yrs dx @ 7 on 13.12.2007 currently using Levemir, Novorapid, Actrapid and Dexcom! and to Philip age 11 nonD

  9. #9

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    So from the paper;
    Following nutritional advice, the patient was started on a gluten-free diet with low glycemic index. The average calorie intake was 7085 KJ/day split into six to seven courses, with 24% energy from carbohydrates, 26% from protein and 49% from fat. HbA1c levels were stabilized at 5.8%-6.0% without insulin therapy. Fasting blood glucose was maintained at 4.0-5.0 mmol/l. The patient gained 1.1kg and 6 cm in height over 1 year
    Also what is interesting is that c-peptide was dropping(as usual)

    Stimulated C-peptide and proinsulin were tested after an invidualised mixed meal (including 35-39g carbohydrates, 5-7g protein and 3-3.5g fat) 8 and 12 months after diagnosis. At 8 months postdiagnosis, stimulated C-peptide was at 580 pmol/l, stimulated proinsulin was 26 pmol/l. At 12 months postdiagnosis, fasting and stimulated C-peptide levels were 2 and 147 pmol/l
    The authors conclude;
    The prolonged remission may be due to the gluten-free diet, the low dietary glycaemix index, the distribution of small meals throughout the day or a combination thereof. Results from animal models suggest that gluten-free diet is a likely cause.

  10. #10

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    Quote Originally Posted by swellman View Post
    It implied he was on insulin the first 3 weeks.
    Patient was treated with insulin for a total of 5 weeks.
    Then
    At the end of the 5 weeks the insulin requirement declined, and the patient entered the remission phase without any insulin requirement for the following 3 weeks, with blood glucose values in the range 4-6 mmol/l. Gluten-free diet was initiated 8 weeks postdiagnosis.

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