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Date: | Fri, 26 Jul 1996 07:52:06 0 |
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Record from database: MEDLINE
Title
Gluten-sensitive enteropathy in patients with insulin-dependent
diabetes mellitus.
Author
Rensch MJ; Merenich JA; Lieberman M; Long BD; Davis DR; McNally
PR
Address
Fitzsimons Army Medical Center, Aurora, Colorado, USA.
Source
Ann Intern Med, 124: 6, 1996 Mar 15, 564-7
Abstract
OBJECTIVE: To determine the prevalence of celiac disease in a
cohort of patients with insulin-dependent diabetes mellitus and
to describe the clinical characteristics of patients with
coexistent disease. DESIGN: Prospective cohort study. SETTING:
U.S. Army medical center. PATIENTS: 47 patients with
insulin-dependent diabetes mellitus. MEASUREMENTS: Antiendomysial
antibody testing was used to screen for celiac disease. The
diagnosis of celiac disease required histologic evidence of
villous atrophy and crypt hyperplasia and a positive
antiendomysial antibody test result. In patients identified as
having coexistent disease, complete blood counts, multiphasic
biochemical testing, D-xylose absorption testing, and bone
mineral density estimates were done. RESULTS: 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 U.S. 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 U.S. population (p less than 0.001).
Two of the three patients with coexistent disease in this study
had subclinical or latent celiac disease.
Brett Saks, BS, DC
Holistic Chiropractor
Atlanta, Georiga
[log in to unmask] e-mail
http://www.mindspring.com/~drbsaks web-site
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