Celiac disease, an inability to digest gluten-containing foods, is more common among diabetics in the U.S. than previously thought, according to a study by Steven Werlin, M.D., professor of pediatric gastroenterology at the Medical College of Wisconsin.The study, published in the October issue of the Journal of Pediatric Gastroenterology, examined 218 children and adolescents with insulin dependent diabetes who were seen in the Division of Gastroenterology and the Diabetes Center at Children's Hospital of Wisconsin and the Medical College.
"We found a 4.6 percent incidence of celiac disease in our study," says Dr. Werlin. "That's significantly more than the one percent or less that is in the general population. Our finding was much closer to what people in Europe have found."
An earlier study by researchers in Buffalo, N.Y., found a one percent incidence of celiac disease in diabetic children.
The 218 patients studied ranged in age from four to 21. Using screening blood tests for the IgA endomysal antibody and small bowel biopsies for confirmation, 10 patients were found to have celiac disease.
Intestinal biopsy is performed with an endoscope, a small tube passed through the mouth. Children are given an anesthetic for this brief outpatient procedure, known as endoscopy. Biopsy findings in unrelated celiac disease include microscopic inflammation and damage of the intestinal lining.
"Our findings suggest we need to be more vigilant in identifying celiac disease in diabetics. People with untreated celiac disease have an increased risk of a form of intestinal cancer and also risk suffering from malnutrition," Dr. Werlin points out. Furthermore, close relatives of those with celiac disease are at a greater risk than the general population of developing the disorder.
"Children's Hospital routinely screens diabetic children for celiac disease," says Dr. Werlin. "Such screening is not routinely done everywhere," he says.
Gluten, the protein to which celiac disease patients are sensitive, is found in wheat, rye, and barley. People with celiac disease must have a gluten-free diet. Avoiding gluten can be difficult. "You'll find that wheat, barley, and rye are in many processed foods. People have to become sophisticated in reading food labels," says Dr. Werlin.
Collaborators in the study include Nur Aktay, M.D., gastroenterology fellow; David Wyatt, M.D., professor of pediatric endocrinology; P.C. Lee, Ph.D., professor of pediatric gastroenterology; Elaine Parton, P.N.P., nurse practitioner, pediatric endocrinology all from the Medical College and Vijay Kumar, Ph.D. from Immco Diagnostics, Buffalo, N.Y. - By Toranj Marphetia
[Contact: Toranj Marphetia]
30-Oct-2001
