DIABETES-MELLITUS AND CELIAC-DISEASE - CLINICAL-STUDY

  • 1 January 1978
    • journal article
    • research article
    • Vol. 47  (185) , 89-100
Abstract
Fourteen adults, in whom diabetes mellitus and celiac disease coexist, are described. In no patient was celiac disease diagnosed (biopsy proven) before the age of 28 yr. Diabetes was recognized before celiac disease in all except 1. Diabetic control was very unstable and hypoglycemia particularly troublesome before treatment with a gluten free diet. Following gluten restriction, insulin requirement increased in 6 patients and diabetic control became more stable. Diarrhea due to celiac disease in a patient with coexisting diabetes, may be mistakenly diagnosed as diabetic diarrhea. However, certain clinical and laboratory features should arouse suspicion that the diarrhea is not of diabetic origin. These include a history of gastrointestinal symptoms preceding the diagnosis of diabetes, the occurrence of repeated hypoglycemia, absence of neuropathy, anemia, low serum folate, low serum albumin and a malabsorption pattern on small bowel radiography. A definitive diagnosis of celiac disease can be made only by jejunal biopsy. The opportunity to diagnose coeliac disease in adult diabetics will usually fall to the diabetologist and wider use of jejunal biopsy in diabetics with chronic or recurrent diarrhea is suggested.