Research: Don’t wait for Symptoms, Test Type 1 Diabetics for Celiac

A call to do routine testing for celiac disease for all type 1 diabetics.  It’s a fact that because type 1 diabetes and celiac disease are both autoimmune disorders that they tend to be prevalent in people diagnosed with one disease but maybe not the other — yet.  But is this enough to make the medical community get on board with routine celiac testing?

The Research:

According to Medscape Medical News*, researchers at the recent Endocrine Society Annual Meeting recommended that pediatric endocrinologists regularly screen their type 1 diabetic patients annually for celiac disease.  The article said, “Importantly, the presence of symptoms should not be a prerequisite for screening.”

“Despite the fact that type 1 diabetics are at increased risk of celiac disease and that there are guidelines for screening from the American Diabetes Association, these have not filtered down to practicing endocrinologists very well,” said Phyllis Speiser, MD co-author of this study and chief of the Division of Pediatric Endocrinology at North Shore Long Island Jewish Health System in New Hyde Park, New York to Medscape Diabetes & Endocrinology.

“At my institution, for example, there is a wide range of opinions among pediatric endocrinologists on when to screen and how to screen…Awareness needs to be raised about this, especially to the fact that celiac disease patients don’t have many obvious symptoms.”  – Dr. Phyllis Speiser

Researchers in this study reviewed the medical records of hundreds of patients of type 1 diabetics from their institution.  Many of which ended up with celiac disease either right away or several years down the road.*

I found the most astonishing note of the study was this: “No type 1 diabetic patient with biopsy-proven celiac disease reported gastrointestinal (GI) symptoms before a definitive diagnosis had been established.”  — In other words, no GI symptoms means many doctors just wouldn’t bother to test these patients for celiac.  “This finding underscores the importance of not delaying screening for celiac disease until  overt GI symptoms present,” said Dr. Speiser.

Conclusion:

While Dr. Speiser believes an annual blood test for celiac is necessary for type 1 diabetics, not all physicians are on board yet.  James L. Rosenzweig, MD and endocrinologist and associate professor at Boston University School of Medicine also talked with  Medscape Diabetes & Endocrinology, “…should we routinely screen all pediatric diabetics for celiac disease?  Even though initial screening would involve only a blood test, a blood test is an added test and the costs add up.  The results are interesting, but I am not yet convinced…”

I’m sure you can tell what my take is, what harm is it to do the blood test on a population of people who are at higher risk of developing another disease that could cause even more health issues down the road?  I am happy some physicians are sticking up for these patients!  Keep spreading the word!

*For the specific data on this research, please refer to the Medscape article. You will have to join Medscape (free of charge) to read the article.

Tags: celiac, diabetes, diabetic, gluten-free, testing, type 1