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Cryptic gluten intolerance in type 1 diabetes: identifying suitable candidates for a gluten free diet

¹ Department of Biology, University of Trieste, Trieste, Italy
² Department of Reproductive and Development Science, University of Trieste and IRCCS "Burlo Garofolo", Trieste, Italy
³ Department of Clinical Science, University of Trieste and Diabetes Service, City Hospital of Trieste, Trieste, Italy
⁴ Department of Reproductive and Development Science, University of Trieste and IRCCS "Burlo Garofolo", Trieste, Italy
⁵ Department of Biology, University of Trieste, Trieste, Italy
⁶ Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM, USA
⁷ Department of Reproductive and Development Science, University of Trieste and IRCCS "Burlo Garofolo", Trieste, Italy

Correspondence to:
Correspondence to:
Dr T Not
Clinica Pediatrica, Istituto per l’Infanzia "Burlo Garofolo", via dell’Istria 65/1, 34100 Trieste, Italy; not@burlo.trieste.it

Keywords: gluten intolerance; diabetes; gluten free diet

The first 150 words of the full text of this article appear below.

Long term exposure to gluten in coeliacs,¹ and coeliac disease (CD) diagnosis after 16 years of age² may induce type 1 diabetes (T1D) and other autoimmune disorders. Increased prevalence of CD among diabetics and their relatives is well documented.³ Early introduction of gluten to children at high risk for T1D produces T1D associated islet autoantibodies.⁴ Similarly, in the absence of overt clinical symptoms of T1D, some coeliac children produce diabetes autoantibodies in a gluten dependent manner.⁵ In diabetics, intestinal challenge with gluten produces mucosal recruitment of lymphocytes,⁶ similar to that in CD patients.⁷ In diabetics, however, there is no production of CD related anti-tissue transglutaminase antibodies (anti-tTG).⁶

We have used a phage display assay⁸ to show that in CD patients, production of anti-tTG is limited to the intestine. Here, we monitored the effects of a gluten free diet (GFD) on anti-tTG antibody synthesis in the intestinal mucosa of a diabetic . . . [Full text of this article]