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Your Baby

Type1 Diabetes and Celiac Disease

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Celiac disease is a serious immune disorder that can occur in children and adults. The disease causes the immune system to attack the lining of the small intestine when gluten is consumed, according to the Celiac Disease Foundation. Gluten is a protein found in wheat. Celiac disease may develop any time after wheat or other gluten containing foods are introduced into the diet, typically after 6-9 months of age.

New research suggests that parents of young children with type1 diabetes should be on the lookout for symptoms of celiac disease as well.

The study found these youngsters appear to face a nearly tripled risk of developing celiac disease autoantibodies, which eventually can lead to the disorder.

"Type 1 diabetes and celiac disease are closely related genetically," explained study author Dr. William Hagopian.

"People with one disease tend to get the other. People who have type 1 diabetes autoantibodies should get screened for celiac autoantibodies," Hagopian said. He directs the diabetes program at the Pacific Northwest Research Institute in Seattle.

Symptoms of celiac disease include stomach pain and bloating, diarrhea, vomiting, constipation, weight loss, fatigue and delayed growth and puberty.

Dr. James Grendell is chief of the division of gastroenterology at NYU Winthrop Hospital in Mineola, N.Y. He explained why knowing ahead of time that celiac may be developing can be helpful. 

"Early diagnosis of celiac disease is important to initiate treatment with a gluten-free diet to prevent complications, particularly growth retardation in children," he said.

"Other significant complications include iron-deficiency anemia, osteoporosis and a form of skin rash. Less common, but potentially lethal, complications include lymphoma and carcinoma of the small intestine," Grendell added.

Treatment for the disease is avoiding eating or drinking anything that contains gluten. Fortunately these days, there are many products that typically contain gluten but are now offered gluten-free. These products usually cost more than their gluten counterparts, but offer more of a variety in the diet.

While the study did find a link between type1 diabetes and celiac disease, that doesn’t mean that type1 diabetes necessarily causes celiac disease.

However, parents should be aware that if their child has type1 diabetes, he or she should be screened for celiac disease. Early intervention with the proper diet can increase the possibility of a good outcome as their child ages.

Story source: Serena Gordon, https://consumer.healthday.com/diabetes-information-10/type-i-diabetes-news-182/where-there-s-type-1-diabetes-celiac-disease-may-follow-727354.html

Your Child

Gluten-Free Diet Not Recommended for Healthy Children

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A “gluten-free “ label on a food product is one sure way to increase sales as the popularity of such items continues to rise.

For people with Celiac disease or gluten sensitivity, eating gluten can cause diarrhea, abdominal pain, upset stomach and bloating. However, for healthy adults and particularly children, there are many reasons to avoid going gluten-free according to a commentary recently published in the Journal of Pediatrics, by Norelle Reilly.

Dr. Norelle Reilly is Assistant Professor of Pediatrics at Columbia University Medical Center and the director of pediatric celiac disease in the Division of Pediatric Gastroenterology and the Celiac Disease Center at Columbia University.

In a recent Time Magazine article, Reilly lays out four reasons why healthy children should not be on a gluten-free diet.

1. Gluten is not naturally toxic except for people with celiac disease, however, in almost all children, gluten travels through the intestine without causing disease and will never lead to problems. To date, science has not shown that there is a toxin in gluten that makes it bad for our bodies. A balanced diet containing fresh fruits and vegetables, lean proteins, and a variety of carbohydrate sources is the best way for healthy children to stay healthy, Reilly notes.

2. A gluten-free diet may not provide balanced nutrition for children. Some people assume that gluten-free food and healthy food as the same thing. Not necessarily so, says Reilly.

Many gluten-free substitutes for items such as breads and cookies are actually higher in fat and calories than gluten-containing varieties. Gluten-free items such as some cereals and breads may also not be nutrient fortified to the same degree as those with gluten. Folate and B-vitamins are often added to our usual starch staples, silently protecting people whose diets may not be very balanced from deficiency. Without these quiet sources of nutrition, vitamin deficiencies could develop, she writes.

Gluten-free foods are often fiber deficient, which is important for gastrointestinal health, including maintaining regular bowel movements. Quite commonly, children who initiate a gluten-free diet become constipated. Increased consumption of rice, a common gluten substitute, may also expose children to more arsenic in their diets, as arsenic is frequently present in the earth where rice is grown.

Reilly says that growing bodies and brains require balanced nutrition. For those children who need a gluten-free diet, balance can be implemented safely and healthfully with the guidance of an experienced registered dietitian to help avoid all of these and other nutritional pitfalls.

3. Have your child tested for celiac disease before putting them on a gluten-free diet. You can’t know for sure whether your child is gluten sensitive or has celiac disease until a physician has tested them. Symptoms alone are not enough to determine whether your child has celiac disease. Being on a gluten-free diet before having your child tested can make it more difficult to determine whether he or she actually does or does not have the disease.

Reilly suggests that if you are concerned that your child may have a problem with gluten, speak to your child’s doctor before banning it from your child’s diet. A child with celiac disease needs special monitoring over time and their family members may need to be tested. Even if you plan to give the diet a try regardless of the test result, it is extremely important for your child and family’s health to know why the diet is necessary.

4. A gluten-free diet is hard to maintain and expensive. For children who require this limited diet for long-term health, parents, schools, and the medical teamwork to make the child’s experience in school and at home as easy as possible.

Reilly notes that the children she has treated for celiac disease would trade in their gluten-free diet in an instant if they knew gluten would not make them sick.

In addition she adds, gluten-free foods are incredibly expensive and for many families the diet can be challenging to financially sustain in the long run.

Many adults prefer a gluten-free diet, but Reilly cautions that parents should check with their pediatrician or family doctor before putting their healthy children on the same eating plan.

Story source: Norelle Reilly, http://time.com/4329517/4-reasons-why-your-kids-should-not-be-gluten-free/

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