If you have diabetes, you know it isn’t the only disease you need to worry about. Celiac disease is often seen in people with type 1 diabetes, affecting as many as one in 20 patients. These diseases together can cause long-term complications if they are not accurately diagnosed early on.
Marilyn McCall, MA, RDN, LDN, a nutritionist with the Diabetes Education Program at Jones Regional Medical Center in Anamosa, Iowa, recently spoke at the 2015 meeting of the American Association of Diabetes Educators. She discussed the occurrence of celiac disease in diabetic patients and the unique set of challenges they present.
Celiac disease is a digestive disorder that is characterized by a sensitivity to gluten, a protein found in wheat, barley and rye. When someone with celiac consumes gluten, the immune system forms antibodies that attack the lining of the intestine. Celiac disease only affects about one percent of the population, but an estimated 40 percent of the U.S. population has the genes for the disease. Celiac can strike at any time in patients who are genetically predisposed to it.
Symptoms of celiac disease may include bloating, diarrhea, weight loss, fatigue and behavioral issues, but not everyone with celiac experiences symptoms. This can make diagnosis difficult, and patients may develop serious complications over time as a result of consuming gluten.
“Obtaining an accurate and timely diagnosis will provide the best possible care and assist in delaying or avoiding long-term consequences such as shorter stature, other food intolerances, nutritional deficiencies related to malabsorption, infertility and problem pregnancies,” said McCall.
Approximately 290,000 individuals have celiac disease and comorbid diabetes. Because patients with an autoimmune disease are likely to develop more than one, type 1 diabetics should be screened regularly for celiac disease. “This means that even though a blood screening came back negative 3 years ago, it should be repeated” said McCall. “And if the blood screening is negative and there is still reason to suspect, a biopsy, which must include four to six sights, should be ordered. However, if a person has the resources to have genetic testing done, then unnecessary time and testing can be avoided.”
Patients who have been diagnosed with celiac should work closely with a dietician to identify and remove any sources of gluten in their diets. McCall also warns that medications can be an unexpected source of gluten. Doctors should screen medications for gluten and periodically check for any formula changes in order to avoid the occurrence of symptoms (Source: Endocrinology Advisor).