Diabetes and Celiac Disease (Part 1)

By Amy Campbell | August 25, 2008 4:36 pm

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[1] wrote about celiac back in April (“Exploring the Gluten-Free World”[2]), so I’ll try not to repeat too much of the information that she shared.

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Celiac disease is an autoimmune[3] 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[4] have celiac. In people with Type 2 diabetes[5], 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:

Some less common symptoms include:

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.

More on celiac next week!

Endnotes:
  1. Jan Chait: http://www.diabetesselfmanagement.com/blog/Jan_Chait
  2. “Exploring the Gluten-Free World”: http://www.diabetesselfmanagement.com/blog/Jan_Chait/Exploring_the_Gluten_Free_World
  3. autoimmune: http://www.diabetesselfmanagement.com/articles/Diabetes_Definitions/Autoimmunity
  4. Type 1 diabetes: http://www.diabetesselfmanagement.com/blog/Type_1_Diabetes
  5. Type 2 diabetes: http://www.diabetesselfmanagement.com/blog/Type_2_Diabetes
  6. hypoglycemia: http://www.diabetesselfmanagement.com/articles/Diabetes_Definitions/Hypoglycemia

Source URL: http://www.diabetesselfmanagement.com/blog/diabetes-and-celiac-disease-part-1/


Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin.

Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.

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