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Question:

From Louisville, Kentucky, USA:

Our 3 year old son was diagnosed several weeks ago but his Islet Antibody test was negative. One strange result was an Anti-gluten IgG result was positive at 29 (reference to 14). We notice that the symptoms of Celiac disease are similar to diabetes, although his A1c result of 12.3% is indicative of only diabetes. Could his strong wheat sensitivity be influencing his diabetes?

Answer:

For some years now it has been recognised that Type 1A or autoimmune Diabetes is quite often associated with other forms of autoimmune disorders, amongst the commonest of which are the celiac syndrome and adrenal insufficiency. Indeed in many centers anti-glutamyl transferase (a test for the celiac syndrome) and anti 21-hydroxylase (a test for adrenal insufficiently) are routinely performed in new onset diabetics. Thyroid insufficiency which is perhaps the most commonly associated immune deficiency of all is also routinely looked for as part of normal management. Grouped together these conditions are now called the Autoimmune Polyglandular Syndrome. Thus wheat sensitivity does not cause the diabetes; but it is linked to it and of course the diet may make the nutritional component of managing the diabetes a little harder. I think you should talk to the doctor about getting the other antibody tests done not that your son is likely to have any adrenal problems; but it may be important to recognise this as a possibility in any future illness. I assume also that your son has had a small intestine biopsy to confirm the diagnosis of celiac disease and that he is already on an appropriate diet.

DOB

Additional comments from Stephanie Schwartz, diabetes nurse specialist:

Measuring just the ICA, and finding a negative result, does not rule out Type 1 diabetes. If the antibody test was done by a commercial lab, and was negative, the result might be unreliable. There are at least two other kinds of antibodies in Type 1 diabetes that can be measured. Ask your son's physician to send a blood sample to the Barbara Davis Center in Denver, or to another "reference lab" for the DPT.

SS

Original posting 29 Dec 1998
Posted to Diagnosis and Symptoms

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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