Type 1 Diabetes

The Gluten File



What is Zonulin???  You need to know!!!

Wheat Consumption May Contribute to Diabetes



Brittle Diabetes can be a sign of celiac disease

From:
Journal of the American Geriatrics Society
Volume 48 • Number 12 • December 2000
PROGRESS IN GERIATRICS
Celiac Disease In Older People
Vicky Tai 1 MB, Morgan Crowe 1 FRCPI, Shaun O'Keeffe 2 MD

"Diabetes is usually diagnosed before celiac disease, and diabetic control is difficult with repeated episodes of hypoglycemia.[65] Diabetic control improves with institution of a gluten-free diet, and insulin requirements increase"


From:
Pathogenesis of Type 1A Diabetes by George Eisenbarth, MD

"Celiac disease, hypothyroidism, hyperthyroidism, Addison's disease and pernicious anemia are some of the most prominent associated diseases. For example approximately 1/20 patients with type 1 diabetes have celiac disease(12;13). Most of these patients are asymptomatic and the disorder is only discovered if anti-transglutaminase autoantibodies are measured and individuals with positive antibodies biopsied. In that the therapy for celiac disease, namely gluten avoidance, is highly effective, at the Barbara Davis Center we routinely screen all type 1 diabetic patients. We also screen for thyroid disease and for Addison's disease (21-hydroxylase autoantibodies)(14). "


New antibody test
"Therefore, Dr. di Tola said, the new test was able to pick up twice as many CD positive patients as did biopsy. The new test could improve the ability to screen for coeliac disease in IDDM1 patients, concluded Dr. di Tola"
Detection of New Antibody Improves Diagnosis of Coeliac Disease in Patients With Type 1 Diabetes



Vitamin D and Diabetes... Can we prevent it?

Vitamin D and Diabetes... Can we prevent it? 
Presentation on YouTube... 48 minutes...
by Frank Garland, PhD, Naval Health Research Center


PubMed Abstracts:



Remission without insulin therapy on gluten-free diet in a 6-year old boy with type 1 diabetes mellitus.
PMID: 22729336  June 2012

Recent studies investigating the underlying mechanisms involved in disease development in diabetes point to the role of the dys-regulation of the intestinal barrier. Via alterations in the intestinal permeability, intestinal barrier function becomes compromised whereby access of infectious agents and dietary antigens to mucosal immune elements is facilitated, which may eventually lead to immune reactions with damage to pancreatic beta cells and can lead to increased cytokine production with consequent insulin resistance. Understanding the factors regulating the intestinal barrier function will provide important insight into the interactions between luminal antigens and immune response elements. This review analyses recent advances in the mechanistic understanding of the role of the intestinal epithelial barrier function in the development of type 1 and type 2 diabetes. Given our current knowledge, we may assume that reinforcing the intestinal barrier can offer and open new therapeutic horizons in the treatment of type 1 and type 2 diabetes.
Leaky gut and diabetes mellitus: what is the link?
PMID:21382153  June 2011

Conclusions: There is an increased prevalence of IgA antitissue transglutaminase antibodies, which suggests the need to use this method as an effective first-line test in the screening of celiac disease in children with type 1 diabetes mellitus.
Prevalence of IgA antitissue transglutaminase antibodies in children with type 1 diabetes mellitus.
PMID: 21567461  May 2011

Conclusions: There is an increased prevalence of IgA antitissue transglutaminase antibodies, which suggests the need to use this method as an effective first-line test in the screening of celiac disease in children with type 1 diabetes mellitus.
CONCLUSIONS Circulating levels of 25(OH)D in children and adolescents with type 1 diabetes vary seasonally and are under the same genetic control as in the general population but are much lower. Three key 25(OH)D metabolism genes show consistent evidence of association with type 1 diabetes risk, indicating a genetic etiological role for vitamin D deficiency in type 1 diabetes.
Inherited Variation in Vitamin D Genes Is Associated With Predisposition to Autoimmune Disease Type 1 Diabetes.
PMID:21441443  March 2011

Restoration of impaired intestinal barrier function by the hydrolysed casein diet contributes to the prevention of type 1 diabetes in the diabetes-prone BioBreeding rat.

PMID: 20853098  Dec 2010

Age at Development of Type 1 Diabetes and Celiac Disease-Associated Antibodies and Clinical Disease in Genetically Susceptible Children Observed from Birth.
PMID: 20056952  Jan 2010

Context: Autoantibodies that are reactive to islet antigens are present at the time of diagnosis in most patients with type 1 diabetes. Additionally, approximately 10% of phenotypic type 2 diabetic patients are positive for at least one of the islet autoantibodies, and this group is often referred to as "latent autoimmune diabetes in adults (LADA)." These patients share many genetic and immunological similarities with type 1 diabetes, suggesting that LADA, like type 1 diabetes, is an autoimmune disease. However, there are differences in autoantibody clustering, T cell reactivity, and genetic susceptibility and protection between type 1 diabetes and LADA, implying important differences in the underlying disease processes.
Latent Autoimmune Diabetes in Adults.
PMID: 19837918  Oct 2009

Celiac disease (CD) presents a wide clinical spectrum. There are asymptomatic or oligosymptomatic forms, which are difficult to diagnose. Since patients with untreated CD can develop severe complications, early diagnosis of these forms is important. Consequently, in groups at risk for CD, such as patients with type 1 diabetes (DM1), screening through determination of antigliadin (AGA), anti-tissue transglutaminase (ATG) and antiendomysial antibodies (EMA) is recommended.
[Study of celiac disease in adults with type 1 diabetes mellitus.]
PMID: 19836858  Oct 2009

The most frequent organ-specific autoimmune diseases associated with type 1 diabetes mellitus in children are hypothyroidism and celiac disease. Among adults, other associations exist, notably with pernicious anemia, which is extremely rare in children.
[Pernicious anemia in an adolescent with type 1 diabetes mellitus.]
PMID: 19211232 Feb 2009

CONCLUSIONS: The prevalence of celiac disease is increased in children and adolescents with DM1 when compared with normality. As most are asymptomatic, it is recommended periodical screening of celiac disease in children with DM1.
[Diabetes and autoimmune diseases: prevalence of celiac disease in children and adolescents with type 1 diabetes]
PMID: 19197454 Dec 2008

The 'A1' genetic variant of beta-casein in milk has been linked to type 1 diabetes (T1D). The keystone piece of supporting evidence is an ecological study positively correlating the incidence of T1D with amount of A1 beta-casein consumption per capita. Of relevance, A1 beta-casein consumption is also positively correlated with latitude, itself implicated in T1D through vitamin D deficiency. Ecological and biological evidence convincingly implicate vitamin D deficiency in T1D. Latitude is a confounder of the ecological data that underpin the hypothesis that A1 beta-casein in cow's milk is a causative factor in T1D. 
Type 1 diabetes, the A1 milk hypothesis and vitamin D deficiency.
PMID: 19100644 Dec 2008

CONCLUSIONS: A genetic susceptibility to both type 1 diabetes and celiac disease shares common alleles. These data suggest that common biologic mechanisms, such as autoimmunity-related tissue damage and intolerance to dietary antigens, may be etiologic features of both diseases
Shared and distinct genetic variants in type 1 diabetes and celiac disease.
 
PMID: 19073967 Dec 2008

SUMMARY: The leaking gut syndrome with subclinical inflammation is associated with beta-cell autoimmunity and type 1 diabetes. Furthermore, treatment of the leakiness has been reported to modulate development of autoimmune diabetes in animal models suggesting that intestinal environment plays a key role in the destruction of insulin-producing beta-cells in the pancreas.
Leaking gut in type 1 diabetes.
PMID: 19122519 Nov 2008

Prevalence of Celiac Disease in Children With Type 1 Diabetes Mellitus Increased in the Mid-1990s: An 18-year Longitudinal Study Based on Anti-endomysial Antibodies.
PMID: 18493223  May 2008

MYO9B (myosin IXB) polymorphisms were associated with celiac disease and ulcerative colitis susceptibility, presumably through alteration of the intestinal permeability. Recently this gene was also associated with several diseases with an autoimmune component, such as rheumatoid arthritis and systemic lupus erythematosus. We aimed to test, for the first time, the potential role of MYO9B polymorphisms in type 1 diabetes (T1D), an autoimmune condition preceded by changes in intestinal barrier integrity. ... Our data suggest an involvement of this MYO9B chromosomal region in T1D predisposition, indicating extensive influence on autoimmune diseases.
Association of MYO9B haplotype with type 1 diabetes.
PMID: 18361936   Feb 2008

Prevalence of autoimmune diseases in islet transplant candidates with severe hypoglycaemia and glycaemic lability: previously undiagnosed coeliac and autoimmune thyroid disease is identified by screening.
PMID: 17257278  Feb 2007

Prevalence of coeliac disease in children and adolescents with type 1 diabetes mellitus in a clinic based population.
PMID: 17308219 Feb 2007

This paper presents a series of 10 hypotheses on the etiology of type 1 diabetes. We begin with the hypothesis that wheat gluten is one of the elusive environmental triggers in type 1 diabetes.
Putting the pieces of the puzzle together - a series of hypotheses on the etiology and pathogenesis of type 1 diabetes.
PMID: 17045415 Oct 2006

Our findings shed light on the basis for the HLA associations in celiac disease and type 1 diabetes.
HLA-DQ2 and -DQ8 signatures of gluten T cell epitopes in celiac disease.
PMID: 16878175  Aug 2006

CONCLUSION: There was a high frequency of additional sources of DSP in patients with DM. These patients more often had sensory symptoms and findings in the hands. Tests that may be useful in the evaluation of DSP in diabetic patients include measures of vitamins B1, B6, B12, serum triglycerides, and immunofixation.
Additional causes for distal sensory polyneuropathy in diabetic patients. PMID: 16484643 Mar 2006

Cryptic gluten intolerance in type 1 diabetes: identifying suitable candidates for a gluten free diet.
PMID: 16344582  Jan 2006

Mice fed a wheat-containing diet showed a higher incidence of diabetes, signs of small intestinal enteropathy and higher mucosal levels of proinflammatory cytokines.
Small intestinal enteropathy in non-obese diabetic mice fed a diet containing wheat. PMID: 15830185 May 2005

The prevalence of CD in this group was 15.8% (3/19). The prevalence of CD in this study group was high, suggesting that those with type I diabetes mellitus should be led as a group of high risk to develop this disease.
Celiac disease in a group of children and adolescents with type 1 diabetes mellitus. PMID: 15761555 Dec 2004

We report on a 15-y-old adolescent boy affected by silent coeliac disease, abnormalities in glycoregulation and with autoantibodies specific to diabetes mellitus type 1 (ICA: islet cell antibodies) and GAD 65 (autoantibodies against glutamic acid decarboxylase), in whom normalization of glycoregulation and disappearance of the immunological markers of pre-diabetes were observed after 6 mo on a gluten-free diet. The patient was followed-up for 36 mo and showed a normal insulin response to an intravenous glucose tolerance test and no markers of autoimmunity. It is possible that undiagnosed coeliac disease over a long period could lead to a direct autoimmune mechanism against pancreatic beta cells. Conclusion: Our findings seem to confirm the theory that undiagnosed coeliac disease can induce an autoimmune process against the pancreatic beta cells and that, following a gluten-free diet, the immunological markers for diabetes mellitus type 1 will disappear.
Regression of autoimmunity and abnormal glucose homeostasis in an adolescent boy with silent coeliac disease.
PMID: 12434905 2002

Dietary gluten has been associated with an increased risk of type 1 diabetes.... In conclusion, signs of mucosal inflammation were present in jejunal biopsies from type 1 diabetic patients, and organ culture studies indicate a deranged mucosal immune response to gliadin.
In vitro-deranged intestinal immune response to gliadin in type 1 diabetes.
PMID: 15220190

Dietary gluten, vitamin D3, and fish-oil are suggested to influence the incidence of autoimmune diabetes.These data support a link between dietary wheat and barley proteins and the development of autoimmune diabetes.
Delayed exposure to wheat and barley proteins reduces diabetes incidence in non-obese diabetic mice. 
PMID: 15093559

Latent autoimmune diabetes of adults (LADA) manifested after the age of 35 is characterized by the presence of disease-specific autoantibodies (anti-glutamate decarboxylase GADAb, anti-IA2Ab). In comparison with T2DM patients, LADA patients were found to express higher antibody activity against gluten-related antigens and against TPO.
Gliadin, endomysial and thyroid antibodies in patients with latent autoimmune diabetes of adults (LADA).
PMID: 12823288

This study emphasizes the high prevalence of CD in patients with DM.
Prevalence of celiac disease and follow-up of EMA in children and adolescents with type 1 diabetes mellitus
PMID: 12827008

The highest antibody response to beta-casein in Type 1 diabetic patients and in patients with coeliac disease could reflect the gut mucosal immune disorders common to Type 1 diabetes and coeliac disease. Furthermore, the elevated beta-casein antibody levels found in LADA patients suggest that the antibody response to this protein may be relevant in autoimmune diabetes.
Antibodies to bovine beta-casein in diabetes and other autoimmune diseases PMID: 12198602

This alteration of intestinal barrier function in non-celiac type I diabetes mellitus, frequently associated with mucosal ultra-structural alterations, could suggest that a loss of intestinal barrier function can be a pathogenetic factor in a subset of insulin dependent diabetes mellitus patients.
Ultrastructural mucosal alterations and increased intestinal permeability in non-celiac, type I diabetic patients.
PMID: 14971814


The highest antibody response to beta-casein in Type 1 diabetic patients and in patients with coeliac disease could reflect the gut mucosal immune disorders common to Type 1 diabetes and coeliac disease. Furthermore, the elevated beta-casein antibody levels found in LADA patients suggest that the antibody response to this protein may be relevant in autoimmune diabetes.
Antibodies to bovine beta-casein in diabetes and other autoimmune diseases.
PMID: 12198602


A1 and B beta-casein may contribute to varying diabetogenicity of cow's milk and explain the difference in incidence of Type 1 diabetes
Variation in consumption of cow milk proteins and lower incidence of Type 1 diabetes in Iceland vs the other 4 Nordic countries.
PMID:12416661

The results of this study indicate that breastfeeding within the first 4 months of life prevents the generation of antibody response to bovine beta-casein despite the mothers' consumption of cow's milk during the breastfeeding period. These findings may have relevance for disease prevention.
Bovine beta-casein antibodies in breast- and bottle-fed infants: their relevance in Type 1 diabetes.
PMID: 11241891

Cow's milk and the new trials for prevention of type 1 diabetes.
PMID: 12809179

The aim of this study was to assess the prevalence of CD in a clinic-based paediatric population with type 1 DM, and to study longitudinal changes in AGA status. Two-hundred-and-eighty-one children and adolescents with type 1 DM aged 9.9 +/- 3.8 yr were screened using AGAs of immunoglobulin A (IgA) and immunoglobulin G (IgG) classes (AGA-IgA and AGA-IgG). Thirty-five patients had both antibodies positive and underwent gastro-duodenoscopy and multiple biopsies. Fifteen of the 35 patients had histological evidence of CD, and the overall clinic prevalence of CD was 5.7% Initial normal screening does not exclude CD and repeat screening is indicated.
Prevalence of coeliac disease and longitudinal follow-up of antigliadin antibody status in children and adolescents with type 1 diabetes mellitus.
PMID: 15016216