<<Disclaimer:  Verify this information before applying it to your situation.>>
 
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Medical Information~Medical Information~Medical Information~
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Much medical information is of no interest to celiacs, but articles are a
simple way to explain an issue to a medical professional.  These extracts
are handy references to show your physician, in his technical language, what
research has been documented throughout the world.  When you encounter a
similar problem, or, if you have a physician willing to learn from a
patient, share these articles for the benefit of all concerned.
 
1.  Approximately 10% of type 1 diabetics may have Celiac.  The disease is
often in "latent" or "silent" form, with no overt symptoms. (1)
 
For example, in a recently published (March 15, 1996) article -- Annals
of Internal Medicine, Vol. 124 Number 6 pages 564-567, entitled "Gluten
Sensitive Enteropathy in Patients with Insulin-Dependent Diabetes
Mellitus", a group of 47 diabetes patients were selected and given
celiac blood tests. Three of the 47 -- i.e. 6% - were positive, and all
three also had positive biopsies.  The article states that two of the
three newly discovered symptoms had absolutely no diarrhea or other so-
called typical celiac symptoms.  The third had only minor symptoms.
 
2.  Diabetes Forecast, April 1996, has an excellent article on Celiac
Disease.  The article gave a very good introduction to CD and its
possibility for those with diabetes.  It does not give details on how a
type I diabetic’s diet, which emphasizes complex carbohydrates and fiber
is incorporated into the diet.
 
A Diabetes and Celiac survey is being conducted by Sara Jones of the
Houston Support Group.  Anyone interested in assisting, please send a
stamped, self-addressed envelope to : Sara Jones, HCSSG, 11011 Chevy Chase,
Houston, TX 77042-2606.
 
3.  Gluten-sensitive enteropathy:
 
   At a conservative estimate, symptomatic gluten-sensitive enteropathy
   affects approximately 1 in 1000 individuals in Europe; however, it is
   now becoming clear that a greater proportion of individuals has
   clinically silent disease, and probably many others have a minor form
   of the enteropathy. In most countries, the clinical presentation has
   changed over the past few years coming closer to the adult type of the
   disease, and the age of onset of symptoms is shifting upward. Liver,
   joint, hematologic, dental, and neurologic symptoms are increasingly
   being recognized. Several diseases are associated with gluten-sensitive
   enteropathy, such as IgA deficiency, insulin-dependent diabetes
   mellitus, and a range of other autoimmune diseases. (2)
 
4.  GSE and insulin-dependent diabetes mellitus:
 
   This study of 47 patients with insulin-dependent diabetes mellitus
   showed that 3 of 47 patients with insulin-dependent diabetes mellitus
   (6.4%; 95% CI, 1.4% to 17.5%) had positive antiendomysial antibody test
   results and small-bowel biopsy specimens consistent with celiac
   disease. The 95% CI lies entirely above the estimated prevalence of
   celiac disease expected in the general US population, which ranges from
   0.02% to 0.1%. Mean bone mineral densities were 0.8 and 1.1 SD below
   age-, ethnicity-, and sex-matched controls in each of the 2
   antiendomysial antibody-positive patients tested. Small bowel
   absorption was abnormal in 1 of the 2 patients tested by D-xylose.
   Anemia and hypoalbuminemia were not detected in any of the patients
   with coexistent disease. Only 1 of the 3 patients had symptoms of
   diarrhea. All patients were at or above their ideal body weights.
   CONCLUSIONS: Celiac disease appears to be more common among patients
   with insulin-dependent diabetes mellitus than in the general US
   population (p less than 0.001). Two of the three patients with
   coexistent disease in this study had subclinical or latent celiac
   disease.  (3)
 
5. DH
 
  A hypothesis describing an immunobiologic basis for dermatitis
  herpetiformis has received considerable experimental support. It states
  that gluten-sensitive enteropathy is the cause of dermatitis
  herpetiformis and in some way leads to the deposition of IgA in the
  skin of patients. Complement is activated in the skin and produces
  immunologic damage at the basement membrane zone. Vesicles are thereby
  produced.... About 90% of human IgA is produced in the bowel. It is
  therefore reasonable to assume that IgA associated with dermatitis
  herpetiformis is also synthesized in the bowel....
 
  Sulfones and sulfapyridine promptly control the cutaneous eruption of
  dermatitis herpetiformis but not the coexisting gluten-sensitive
  enteropathy. ... A gluten-free diet not only allows the bowel to heal
  promptly but also induces a remission of the skin disease, although the
  latter may take months. Even if remission is incomplete, a gluten-free
  diet may allow dapsone to control the disease at a lower dose.  (4)
 
6.  How should a person with celiac disease be referenced?  The attachment
of the word disease to our allergy/intolerance creates an impression about
the condition that is entirely false.  As long as the diet is followed, we
do not have an untreatable disease.  But without a qualifier, the medical
communities and the Government downplay the requirement to understand the
actual ingredients used in a product.
 
So regardless of the term used: Celiac Disease, Celiac Sprue, Gluten
Intolerant, or Celiac, the only restriction is what you feel is the
appropriate term.  Many people are beginning to refer to themselves as being
a Celiac.  When additional questions are asked, they state that there is the
requirement to maintain good health through a controlled diet.  This is
especially true for teenagers.