Research into the domain has revealed that Celiac disease and Type 1 diabetes are both autoimmune ailments that have overlapping pathogenic and clinical symptoms and relations. Early 8% of Type 1 diabetes has been found to have the ailment traces of Celiac disease. More often than not, many patients suffering from Type 1 Diabetes problems do not have the classic symptoms of Celiac Disease , which is why doctors often recommend a Celiac disease screening amongst the high-risk Type 1 Diabetes patients. In both these ailments, the factors of HLA genetics seem to play a very important. Apart from HLA genetics the aspects of environmental factors also happen to play a very imperative role.
Link Between Celiac Disease and Type1 Diabetes
In both these ailments, certain antibodies seem to play a very important role that trigger off both the conditions in patients. In the case of Celiac disease , an immune-mediated polygenic systematic enteropathy is triggered due to an adverse reaction to dietary gluten. Type 1 Diabetes is also a condition where the destruction of the body beta cells is done due to the mediation of the antibody. It occurs out of the pancreatic islets and affects blood glucose levels (1).
Doctors deliberately ask patients of either condition to test for the other as knowledge and information of one condition helps to manage the other condition as well.
Incidence and Prevalence of Celiac Disease and Type1 Diabetes
The rate of overlapping between these two ailments is a variable one throughout the world. However, the rate is on an increase in the current times. Patients suffering from type 1 diabetes have the background of genetic factors combining with other environmental aspects and immunological deficits which makes them rather prone to developing other autoimmune disorders of which Celiac disease is one of the most common problems that has been traced in them. In order to understand this aspect, research has been done on the Caucasians that has confirmed the trend (1).
Symptoms of Overlapping Celiac Disease and Type 1 Diabetes
Patients with a problem of Celiac disease can have general symptoms common to the problem or can be devoid of any symptom at all. The symptoms of Celiac disease can surface in a person at any time during the stages of adulthood. Some of the common symptoms are diarrhea, heartburn, bloating and even weight loss. If symptoms of Celiac disease emerge in a child then that child can have to face the problem of inadequate growth. However, there can be cases of Celiac disease where the patient might not have regular symptoms and indications. Most often than not the Type 1 Diabetes patients do not exhibit any symptom of the Celiac disease . Although some of them can exhibit slight indications of gastrointestinal problems (1). Researches into the domain confirm the fact that nearly 75% to 90% of the children who are affirmed with Type 1 Diabetes symptoms also develop Celiac disease symptoms at a later stage. The rate is the highest amongst children younger than 4 years old. Celiac disease detection is generally done at an average age of 8 years.
Encouraged Diagnosis of Overlapped Coeliac Disease and Type 1 Diabetes
These days the doctors are increasingly encouraging the screening of Celiac disease in patients of Type 1 Diabetes , due to the lack of symptoms for Celiac disease in the Type 1 Diabetes patients. As a result of the detection of Type 1 Diabetes, a screening for Celiac disease is being done at the initial stage and then after four years and then once every two years for the upcoming six years. The diagnosis screening is done on the basis of particular serology tests. The most accurate and sensitive serology test done to screen Celiac disease is transglutaminase IgA, IgA antibodies, endomysial (EMA). Biopsies of the small intestine are also a sure shot way of screening Celiac disease in a person. Often patients of Type 1 Diabetes might lack the general symptoms of Celiac disease in the face of which a small intestine biopsy happens to be the only way through which Celiac disease screening can be done.
Treatment of Celiac Disease and Type 1 Diabetes Overlapping Patients
Treatment of Celiac disease patients with Type 1 Diabetes condition is similar to patients with Celiac disease symptoms alone. A strict gluten-free diet is to be started for them and must be maintained in the times to come, at least till when the treatment is being done. It is best that the patient must get in touch with a professional dietician who can help them with the ideal diet that needs to be followed in this condition. Along with a gluten-free diet, the patient must also begin with an intake of multivitamins as this is a physical condition when the body lacks a number of essential and vital vitamins and minerals. With proper treatment and the right kind of diet, a maximum number of patients will experience a considerable benefit and improvement in the immediate fortnight’s time. Serologies must be visited at regular intervals for the next three to four months and then once every year (1).
Patients who have been diagnosed with both Type 1 Diabetes and Celiac disease maintaining the dietary specifications can be a considerable challenge. These patients can experience a certain compromising lifestyle as well. Patients with Type 1 Diabetes alone is said to have a better quality of lifestyle as compared to patients who have both Type 1 Diabetes and Celiac disease . Investigations confirm that following a gluten-free diet in patients of Type 1 Diabetes with a condition of Celiac disease can be beneficial and not particularly detrimental. However certain exceptions can also emerge with varying clinical specifications of different patients (1).
The investigation into the domain has revealed the fact that various genetic disorders can play a significant role that causes the overlapping of these two ailments in a number of patients across the world. Apart from that certain common environmental problems also contributes to this concurrence. Problems like breastfeeding practices and subsequent exposure to viral infections, infant feeding habits, early introduction of cereals amongst infants and other infections especially caused by virus attacks increase the concurrent attacks of both Type 1 Diabetes and Celiac disease ailments amongst children and infants. The existence of gut microbiome is also a major component in this context.
There can be different exceptions to all the general conclusions. However, the ones mentioned are some of the common aspects that trigger off both the diseases in people of different ages and especially children
Cohn A, Sofia MA, Kupfer SS, Type 1 Diabetes and Celiac Disease: Clinical Overlap and New Insights into Disease Pathogenesis, Curr Diab Rep. 2014 Aug; 14(8): 517., doi: 10.1007/s11892-014-0517-x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4156157/