Friday, August 19, 2011

Type 1 diabetes mellitus and celiac disease: endothelial dysfunction.

I'm going to try out something a bit different here.

Since so much of my reading and research are deep in conventional medical journals, I want to help everyone to understand what the current research is saying.  I'm going to bring a citation here and then convert it into layspeak.
Infographic Type 1 diabetes and celiac

If you have a question about the translation, ask in the comments.
This way more folks will be able to ask their physicians pertinent questions and get better care.
Today's citation comes to us from an Italian Journal of Diabetology.
I'll interject in This Font
Type 1 diabetes mellitus and celiac disease: endothelial dysfunction.
Acta Diabetol. 2011 Jun 21;
Authors: Picarelli A, Di Tola M, Sabbatella L, Mercuri V, Pietrobono D, Bassotti G, D'Amico T, Donato G, Picarelli G, Marino M, Borghini R, Centanni M, Gargiulo P
Many reports indicate a hypercoagulative state in diabetes mellitus as result of endothelial  damage.
Many reports indicate a clot forming state in diabetes as a result of inner blood vessel wall damage. 
Experimental evidence suggests that a metabolic derangement triggers a cascade of biochemical events that lead to vascular dysfunction.
There is likely a metabolic derangement that sparks the inner blood vessel wall damage
The net effect is to convert the endothelium from thromboresistant to thrombogenic surface.
The net result is to make the inner blood vessel walls likely to form clots
In literature, a strong association between type 1 diabetes mellitus (DM1) and celiac disease (CD) has been reported. We do not have information about the hemostatic system in these associated conditions. Our study aims at evaluating whether the presence of CD in a group of DM1 patients is associated with a different expression of some hemostatic factors and with a different manifestation and/or progression of microvascular complications of DM1 in comparison with patients with only diabetes.
There is a strong association between Type 1 (childhood onset, insulin dependent) Diabetes and Celiac disease.  There is no information about the vascular system in tandem for these diseases
Ninety-four adult DM1 patients were enrolled in the study and subsequently screened for CD. Anti-endomysial antibodies (EMA) were positive in 13 of 94 DM1 patients (13.8%). CD diagnosis was confirmed by histology and organ culture. The mean age and duration of DM1 of patients also affected by CD were similar to those of only diabetic patients, but the metabolic control and the hemocoagulative parameters were significantly different between the two groups:
The researchers gathered 94 diabetic type 1 patients, 13 were proven to have celiac disease by blood test and biopsy. The patients were matched for age and duration of disease, so they should have had similar blood vessel results.
DM1 patients also affected by CD presented significantly lower concentrations of glycosylated hemoglobin (HbA1c) (P < 0.05), cholesterol (P < 0.001), triglycerides (P < 0.001), factor VII antigen (FVII:ag) (P < 0.005), factor VII coagulant activity (FVII:c) (P < 0.05), and prothrombin degradation fragments (F1+2) (P < 0.001), as well as higher values of activated C protein (APC)Our results suggest a potential protective role of CD in the prothrombotic state of DM1.
PMID: 21691748 [PubMed - as supplied by publisher]

Their results suggest a Protective role of celiac disease in the blood vessel viability of Type 1 Diabetic patients.
So this suggests that

being celiac might help a type 1 diabetic avoid some of the common problems of diabetes.

Was this interesting?  Are you curious to learn more about the pluses and minuses of celiac and gluten intolerance?

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