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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
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