Diabetes and Celiac Disease (Part 1) :: Diabetes Self-Management

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Aug 25, 2008

Diabetes and Celiac Disease (Part 1)

Amy Campbell

You may recall that I attended the American Association of Diabetes Educators (AADE) annual meeting a few weeks ago. When I arrived at the conference on Wednesday, I was a little late getting to the 1:30 session that I really wanted to go to and, as a result, got closed out. I then wandered across the hall to another session called "Managing Diabetes with Celiac Disease."

I figured, "What the heck, this will be a good review for me." I have to say that I'm really glad I attended, and I wanted to share some things that I learned. I know that Jan Chait wrote about celiac back in April ("Exploring the Gluten-Free World"), so I'll try not to repeat too much of the information that she shared.

Celiac disease is an autoimmune digestive disorder that is caused by eating foods that contain gluten, a type of protein found in wheat, rye, barley, and possibly oats. When a person with celiac eats a food that contains gluten, an immune reaction occurs that results in damage to the villi of the small intestine. Villi are finger-like projections that protrude from the lining of the small intestine and help increase the surface area, allowing nutrients to be absorbed at a fairly fast rate. With celiac, these villi are damaged and flattened out, leading to malabsorption.

If celiac isn't treated, nutrient deficiencies can result, causing problems with the nervous system, bones, and liver. People with untreated celiac are also at an increased risk for intestinal lymphoma and bowel cancer.

Facts and Figures
About three million people in the U.S. have celiac disease, but only 5% (150,000) are actually diagnosed. Twenty-five percent of new diagnoses occur in adults older than 60 years of age. And 6% of people with Type 1 diabetes have celiac. In people with Type 2 diabetes, about 1 in 250 have celiac. Having a family history of celiac increases the risk by between 5% and 15%. Celiac disease tends to be more common in people of European ancestry, as well as in people who have autoimmune diseases, including Type 1 diabetes, lupus, rheumatoid arthritis, and autoimmune thyroid disease.

Symptoms
Celiac disease often goes undiagnosed for many years. This is in part due to the malabsorption symptoms that occur, and health-care providers often look for other possible causes, such as irritable bowel syndrome, ulcers, and Crohn disease. Also, some people with celiac never get any gastrointestinal symptoms, which makes celiac even trickier to diagnose. However, some of the more common symptoms of celiac are:

Diarrhea
Abdominal pain
Bloating
Vomiting
Lack of appetite
Failure to thrive (in children)

Some less common symptoms include:

Anemia
Osteopenia (low bone density)
Fatty liver
Recurrent miscarriages
Short stature (in children)
Skin rash
Unexplained hypoglycemia (in people with diabetes)

In fact, celiac can affect all of the body's systems, not just the gastrointestinal tract. A particular skin condition called dermatitis herpetiformis (DH) is linked with celiac. DH is characterized by red bumps and blisters that cause intense itching, burning, and stinging. These lesions are symmetrically found on the elbows, legs, buttocks, shoulders, neck, and back. Diagnosis of DH is done by biopsy, and although medicine is prescribed, a strict gluten-free diet must be followed. In most cases, eating foods with gluten will trigger an outbreak of this skin condition, even if the condition has been healed.

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I would like to know more about Celiac and Diabetes. I know a little girl who has Celiacs and I did'nt know the 2 were connected????????Also Celiacs and diabetes in older people????

Posted by: Gette | Aug 27, 2008 02:21 PM

Hi Gette,
Keep in mind that not everyone with celiac has diabetes, and vice versa. However, both are autoimmune diseases and there definitely seems to be a link. For more information, check out Celiac.com at www.celiac.com.

Posted by: acampbell | Aug 27, 2008 02:42 PM

Please keep in mind that you don't go along just fine and one day you wake up with celiac disease (CD). You develop a sensitivity to gluten first before it develops into full-blown CD. So if you have some of the symptoms of CD, such as anemia, bloating, etc., but your doctor says you don't have the flattened villi (which is indicative of full-blown CD), you may have a gluten sensitivity. In this case, you should eliminate gluten from your diet immediately, to prevent CD from developing. Some experts have estimated that as many as 30% of our population have gluten sensitivity which may eventually develop into CD.

Posted by: slstanley1 | Aug 27, 2008 07:34 PM

I was told my by Dr. that the bumps were a part of diabetes (and I thought myself - wacko mutant roseacea), not part of being a celiac sufferer (10 years). I have something else to ask my Dr at the next visit.

Having European ancestry is becoming a hindrance with Rosecea and Celiac. Now with diabetes type 2 I have hit my medical Trifecta?

Posted by: joywinter | Aug 28, 2008 09:38 AM

Hi joywinter,
Actually, your "skin bumps" may still be due directly to your diabetes, and not necessarily your celiac. But either way, please ask your doctor about this at your next visit.

Posted by: acampbell | Aug 28, 2008 02:03 PM

Hi slstanley1,
There is a condition called gluten sensitivity that is similar to celiac in terms of its symptoms, but apparently doesn't cause damage to the small intestine. Some medical professionals are doubtful as to the existence of gluten sensitivity. It's true that symptoms of celiac don't just appear all of a sudden. However, symptoms such as anemia, bloating, and diarrhea should be properly diagnosed by a healthcare professional, as these can be due to other health conditions. One doesn't necessarily have gluten sensitivity or celiac just because these symptoms are present. If causes of these symptoms (including celiac) are ruled out, it's certainly not harmful to go on a gluten-free diet, as long as it's nutritionally-balanced. Again, if celiac disease is at all suspected, it's important to get it properly diagnosed, especially before going on a gluten-free diet on one's own.

Posted by: acampbell | Aug 31, 2008 06:08 PM

Hi,

I am a 61 year old female with Celiac Disease and Hepatitis C. Since last retested about a year ago, the Hepatitis has not progressed past stage one...knock on wood. The Celiac Disease was not diagnosed until I was put on Inferreron / Rivoviron treatment in my late 40's for the Hepatitis, which I had to be taken off of due to the celiac which became full blown.

Up until then the main symptoms I had was Dermatitis Herpetiformis and migraine like headaches that started in my 30's which got more frequent and lasted longer as I got older; and I always had a bloated stomach until I was put on a celiac diet. The only medication that helps the headaches is Dihydroergotamine Mesylate Injection, USP commonly known as D.H.E. 45. It has to be taken inter-muscular as soon as I feel a headache coming on. I still get these headaches even though I adhere to a strict celiac diet but they seem to be getting a little less frequent with age.

Now I have a new skin problem which is also related to the immune system called granuloma annulare. The dermatologists don't have a cure only steroid cream which can thin your skin. Not a good thing on aging skin!! Also I just found out that I am borderline diabetic.

I am trying an alkalizing diet with no sugar. I grind my own grains (millet, quinoa, flax seed, almonds, and sesame seeds) and add sea salt and water to make pancakes. I also drink ionized pure water with fresh lime and green tea. I was using soy milk for the pancakes but it has sugar in it.

If you think any of these grains contain any danger please let me know.

Thank you.

Posted by: owka4u | Sep 15, 2008 02:14 PM

Hi owka4u,

You certainly have had a lot on plate! Fortunately, millet and quinoa are gluten-free grains so feel free to enjoy them. Flax seed, almonds and sesame seeds aren't grains and therefore don't contain gluten, either. Best wishes for all of your efforts!

Posted by: acampbell | Sep 15, 2008 03:14 PM

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