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Complications of Diabetes

Coeliac disease and diabetes

What is Coeliac disease?

WheatCoeliac disease is caused by sensitivity or allergy to Gliadin which is the principle protein found in certain cereals such as wheat, barley and rye. The resulting immune reaction causes inflammation in the lining of the small intestine which leads to damage causing diarrhoea and malnutrition. People who have coeliac disease may develop anaemia due to problems with absorption.

What are the symptoms of coeliac disease?

  • chronic diarrhoea
  • generalised fatigue or weakness
  • anaemia
  • weight loss

The symptoms are very non-specific so many people go through life without finding a good reason for their tiredness or abdominal symptoms.

The majority of people with coeliac disease are adults who do not have any symptoms.

Who is likely to develop coeliac disease?

Coeliac disease tends to run in families. About one in a thousand people are known to have the condition though the actual figures may be higher. It is more common in people with type 1 diabetes which is a related auto-immune condition.

How is the condition diagnosed?

Antibodies to gliadin may be detected in the blood. The diagnosis of celiac disease is usually confirmed by taking a biopsy from the duodenum (small bowel just beyond the stomach)  using an endoscope passed down the oesophagus (food passage).

Can it be cured?

There is no cure for coeliac disease as yet, neither is it possible to prevent the onset in those susceptible. A diet free of gluten will help the damaged bowel lining recover and symptoms usually improve. People who have a gluten allergy find that a gluten-free diet transforms their quality of life.

How strong is the link with type 1 diabetes?

It is estimated that between 3 to 8% of people with type 1 diabetes have coeliac disease.

How important is diet?

Diet forms the mainstay of treatment in coeliac disease. When children fail to improve on diet, hidden sources of gluten can often be found by a skilled dietician. The restrictions on diet are more rigid than in those who have diabetes alone.

Where can I get more information?

The Coeliac Society
PO Box 220
High Wycombe
Bucks HP11 2HY
Tel: 01494 437278
www.coeliac.co.uk

 

Dr Nishan Wijenaike
Consultant Diabetologist
West Suffolk Diabetes Service
Bury St Edmunds
September 2004