<<Disclaimer: Verify this information before applying it to your situation.>>
 
On Jul 20, 1996 21:16:16, '"Mary F. Hicks" <[log in to unmask]>'
wrote:
 
>I just read an article on celiac disease in Diabetes Forecast....  I have
>been a type I diabetic for around 25 years and have always experienced
>alternating diarrhea and constipation even before diabetes.  More recently
>I experienced symptoms which my endocrinologist attributed to gastroparesis:
 
I'm posting some of this to the list because this combination hasn't been
discussed before. As a Type I,  my gastroscopy for celiac dx also revealed
otherwise silent gastroparesis- food still in the stomach that early AM
after a half day's liquid diet. Such nerve damage is common in diabetics.
 
I've read the article in this magazine read mostly by diabetics and
diabetic paramedicals: it's right on the 1 celiac in 20 of Type Is, wrong
on the 1 in 2000 for the rest of the population and hence Type IIs. It
neglects those Type I's who might show up without overt symptoms. It makes
a big thing of diarrhea, likely becase someone years ago published a case
report in which initially unexplained diarrhea in a Type I was finally
diagnosed as celiac. (I found an article on "refractory  diabetic diarrhea"
, likely refractory celiac in a Type I.) DIarrhea in my experience is not a
symptom of either Type I or Type II diabetes.
 
Gastroparesis, nerve damage to the food mixing and moving muscles in the
stomach and intestines, has several independent symptoms, each present or
absent to varying degrees. It's possible that nerve damage has increased or
shown up in another place as well for the belching, vomiting. Instead of
drinking that tagged meal so they can watch it being moved, watch your
blood sugar to see when it peaks after eating. If about two hours, then any
stomach part to the gastroparesis is being correctly handled by the
Propulsid. Any intestinal part effects more the amount than the timing,
since the carbohydrates get digested much faster.
 
Uncorrected gastroparesis typically creates wild swings in blood sugar for
the Type I-- sugar  may even go so low after a meal that the liver dumps
sugar to fill in until the stomach finally empties: glucose is then high at
the next meal and may go lower than expected  later as the liver
"recharges".
 
As for the celiac, resist the temptation to go on the diet without at least
the endosymial antibody test first. Blood work  on iron, folate, vitamins
may be useful. Perhaps ankle edema or low sodium. If the antibody is
positive, perhaps you can skip  the biopsy for now, just go on the diet.
You'll likely need a gastroscopy later for gastritis, so let that also be
to verify healing. Given your long history of diarrhea, there may be an
ulcer to find as well.
 
                                  Kemp Randolph
                                  Long Island