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Diabetes - Juvenile Community
This patient support community is for questions related to juvenile diabetes including celiac disease, depression, diabetic complications, hyperglycemia / diabetic keto-acidosis, hypoglycemia, islet cell transplantation, nutritional issues, parenting a diabetic child, pregnancy, pump therapy, school issues, and teens with diabetes.
Doctor's Answer
by JDRF-Team-jhg, Oct 20, 2003 12:00AM
waterside:
Here is some information that will hopefully answer your questions. If you have any additional questions, don't hesitate to get back to me and I'll do my best; hope all goes well with your grandson!
Classically, celiac disease "presented" with diarrhea, failure to thrive (delayed growth), and abnormal stools. It was considered to be a rarity, affecting 1 in nearly 4000 people. In the past few years however those beliefs are being shattered as a rapidly growing population of undiagnosed "silent celiacs" is being discovered in the USA. Some researchers believe that as many as 1 in 133 people may have it, only 1/3 of whom "present" with diarrhea & 40% of whom have NO symptoms.
Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine. When someone with celiac consumes gluten - the protein found in wheat, rye, & barley, his or her immune system responds by causing an inflammation of the lining of the small intestine that results in malabsorption of important nutrients into the body. Undiagnosed and untreated, celiac disease can lead to other autoimmune disorders, osteoporosis, infertility, neurological conditions and years of misdiagnosis by doctors unfamiliar with this growing problem.
Recently released studies (October 2003 issue of the Journal of the American Medical association: JAMA -- Norris et al. 290 (13): 1713) theorizing that the introduction of gluten (the proteins that comprise grains) triggers a reaction in an under-developed immune system of a baby that can result in heightened autoimmune sensitivity in those children predisposed genetically. The body's inability to tolerate gluten damages the proximal ( upper) portion of the intestine, depriving the body of essential nutrients. Even something as seemingly unrelated as emotionally needy/ clingy children is believed to be related, since these children may never feel quite "right". More interesting still are other listed symptoms of infertility, low birth weight babies, hypothyroidism, irritable bowel, osteoporosis. The absence of acute intestinal distress is no guarantee that one doesn't have celiac, if another family member has been diagnosed, or if there are already autoimmune conditions diagnosed.
The "good news" is that almost magically, by totally removing gluten (
bagels, pizza, cookies, cereal, pretzels, etc) from one's diet, the body "heals" itself so well within a matter of days, weeks or months.
The bad news is that this is a lifelong dietary change. Even tiny amounts of unseen gluten in caramel coloring, in malt, in modified food starch, in soy sauce ( usually contains wheat), etc can perpetuate the autoimmune "storm" that rages within the intestines of a person with Celiac.
Have your son or daughter call your grandson's doctor & request that blood be drawn for the antibody testing. The blood can be drawn anywhere, but the lab which will assess the results is critical in order for accurate interpretation. The complete celiac antibody screening should include:
anti-gliadin (AGA) IgA
anti-Gliadin (AGA) IgG
IgA anti-tissue transglutaminase (tTG)*** This is the more recent test & has proven to be very predictive. High antibody levels are usually indicative of celiac disease, but should be confirmed by an intestinal biopsy. Once again, if not read by a pathologist who is very familiar with these biopsies, the results may be dubious.
Finally, if the diagnosis for celiac is positive your son or daughter should also make an appointment with the Celiac Center nutritionist and work with them to create a gluten free meal plan and begin the healing process for your grandson.
Here is some information that will hopefully answer your questions. If you have any additional questions, don't hesitate to get back to me and I'll do my best; hope all goes well with your grandson!
Classically, celiac disease "presented" with diarrhea, failure to thrive (delayed growth), and abnormal stools. It was considered to be a rarity, affecting 1 in nearly 4000 people. In the past few years however those beliefs are being shattered as a rapidly growing population of undiagnosed "silent celiacs" is being discovered in the USA. Some researchers believe that as many as 1 in 133 people may have it, only 1/3 of whom "present" with diarrhea & 40% of whom have NO symptoms.
Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine. When someone with celiac consumes gluten - the protein found in wheat, rye, & barley, his or her immune system responds by causing an inflammation of the lining of the small intestine that results in malabsorption of important nutrients into the body. Undiagnosed and untreated, celiac disease can lead to other autoimmune disorders, osteoporosis, infertility, neurological conditions and years of misdiagnosis by doctors unfamiliar with this growing problem.
Recently released studies (October 2003 issue of the Journal of the American Medical association: JAMA -- Norris et al. 290 (13): 1713) theorizing that the introduction of gluten (the proteins that comprise grains) triggers a reaction in an under-developed immune system of a baby that can result in heightened autoimmune sensitivity in those children predisposed genetically. The body's inability to tolerate gluten damages the proximal ( upper) portion of the intestine, depriving the body of essential nutrients. Even something as seemingly unrelated as emotionally needy/ clingy children is believed to be related, since these children may never feel quite "right". More interesting still are other listed symptoms of infertility, low birth weight babies, hypothyroidism, irritable bowel, osteoporosis. The absence of acute intestinal distress is no guarantee that one doesn't have celiac, if another family member has been diagnosed, or if there are already autoimmune conditions diagnosed.
The "good news" is that almost magically, by totally removing gluten (
bagels, pizza, cookies, cereal, pretzels, etc) from one's diet, the body "heals" itself so well within a matter of days, weeks or months.
The bad news is that this is a lifelong dietary change. Even tiny amounts of unseen gluten in caramel coloring, in malt, in modified food starch, in soy sauce ( usually contains wheat), etc can perpetuate the autoimmune "storm" that rages within the intestines of a person with Celiac.
Have your son or daughter call your grandson's doctor & request that blood be drawn for the antibody testing. The blood can be drawn anywhere, but the lab which will assess the results is critical in order for accurate interpretation. The complete celiac antibody screening should include:
anti-gliadin (AGA) IgA
anti-Gliadin (AGA) IgG
IgA anti-tissue transglutaminase (tTG)*** This is the more recent test & has proven to be very predictive. High antibody levels are usually indicative of celiac disease, but should be confirmed by an intestinal biopsy. Once again, if not read by a pathologist who is very familiar with these biopsies, the results may be dubious.
Finally, if the diagnosis for celiac is positive your son or daughter should also make an appointment with the Celiac Center nutritionist and work with them to create a gluten free meal plan and begin the healing process for your grandson.
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Tks for the rapid reply to my question about celiac disease and type 1 diabetes in a 4 1/2 yr.old. What exactly do you mean by "high" antibody levels? I live in Canada so hopefully you can put this in terms that I would understand. I realize that the measurement is listed differently in the U.S. just like you measure cholesterol in both countries. What is considered "NORMAL" for a child and what would be "unacceptable?" waterside