Celiac disease: doubly risky for diabetics

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Many type 1 diabetics are sensitive to the cereal protein gluten. Not only does it cause digestive problems in them, the blood vessels burdened by increased blood sugar also suffer more than in diabetics who can tolerate gluten.

This is particularly noticeable in the finely branched blood supply in the eyes and kidneys. Type 1 diabetics who also suffer from celiac disease are, on average, much more likely to develop so-called retinopathies, in which the eyesight fades, or nephropathies, in which the kidneys are damaged. This was the result of a study with 56,514 patients from 392 diabetes centers in Germany and Austria.

Early onset of consequential damage

A research team led by Prof. Reinhard Holl from the Diabetes Mellitus Competence Network found retinopathy in a quarter of the recorded diabetes patients with celiac disease at the age of 26. That is seven years earlier than for diabetics without celiac disease. In addition, a quarter of the patients with both clinical pictures announced the onset of kidney disease at the age of 32 - ten years earlier than in patients who only suffered from type 1 diabetes.

Often in a double pack: Diabetes & Celiac Disease

The results are significant because celiac disease occurs in a large number of type 1 diabetics - one in ten in the study. The reason: the hypersensitive reaction of the body to the adhesive protein and the auto-aggressive action of the immune system against the insulin-producing cells of the pancreas are based on the same genetic variant.

Celiac test recommended

"People with type 1 diabetes should be examined for celiac disease at the time of diagnosis and at regular intervals," says study leader Holl. Whether a gluten-free diet, as recommended for celiac disease, can actually minimize the risk of the complications described in type 1 diabetes has yet to be researched.

Immune system in turmoil

Celiac disease is a chronic disease of the small intestine that is based on an intolerance to the adhesive protein gluten. This occurs in common types of grain such as wheat, spelled, rye, barley and oats. In people with celiac disease, the immune system reacts to gluten, which leads to bulging pain, gas, and greasy diarrhea. In the long term, the intestinal mucosa is damaged. Then nutrients can be absorbed much more poorly by the body.

According to the German Society for Celiac Disease, one in 200 people in this country suffers from celiac disease. However, the majority of those affected do not have a full picture of the disease. This means that many people have been shown to have celiac disease, but the symptoms are minor or moderate. (cf)

Source:

Rohrer, T. R., et al: DPV Initiative and the German BMBF Competence Network Diabetes Mellitus. 2015. Microvascular Complications in Childhood-Onset Type 1 Diabetes and Celiac Disease: A Multicenter Longitudinal Analysis of 56,514 Patients From the German-Austrian DPV Database. Diabetes Care, 38: 801-7. doi: 10.2337 / dc14-0683. Epub 2015 Feb 17.

Press release Diabetes Research Group at the Technical University of Munich, May 21, 2015

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