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From Watertown, South Dakota, USA:

My daughter who is 6 was diagnosed in January 1998. She has done extremely well with blood sugar control. Her A1cs have been good, but she complains of stomach aches often. I know there is a disorder common to young people with diabetes called 'coeliac syndrome'. I don't know much about it. Where can I find more information on diagnosis and treatment of this disorder? Also, are people with Type 1 diabetes prone to any immune system disorders? It seems we fight constant illness.


Up to 10% of Caucasian Type IA Diabetics in the U.S. have celiac disease as defined by a positive test for anti-transglutaminase antibodies. After hypothyroidism it is the commonest component of the Autoimmune Polyglandular Syndrome and with a third autoimmune component, adrenal isufficiency, defined by anti 21-hydoxlase antibodies, is coming to be part of routine initial testing of new onset diabetics.

Most cases are asymptomatic and many Centers think that a small intestine biopsy of the mucosa should be done to confirm the diagnosis. The correspondence between biopsy and antibody testing has been so good however that some dispense with the biopsy. Since the effect of the autoimmune process is to create a sensitivity of the small bowel lining to wheat gluten, treatment involves the elimination of this protein.This is not something to be undertaken lightly in an asymptomatic child and the reason for doing it is the evidence that left untreated there is an increase in later life of lymphoma of the bowel.

Malabsorption of dietary fat is the main symptom of the clinical phase and abdominal pain is not usually part of the picture. For this reason I wonder if this problem in your daughter might not be due to hypoglycemia in view of her excellent control, something that would be easy to check. It is perhaps also worth remembering that abdominal pain is a very common symptom of stress, especially in girls.


Original posting 27 Mar 1999
Posted to Other Illnesses


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