Type 1 diabetes mellitus and celiac disease: usefulness of gluten-free diet
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Paola Pascolo Elena Faleschini Giorgio Tonini Alessandro Ventura
- چاپ و سال / کشور: 2011
Description
et al. [1] describing metabolic control and selected hemocoagulative/ anticoagulant parameters in patients with isolated type 1 diabetes mellitus (T1DM) and in those affected by celiac disease (CD) too. According to our experience at Pediatric Endocrinology Unit of Trieste, we respectfully disagree with Picarelli’s conclusion and otherwise support the importance of a gluten-free diet (GFD). Picarelli et al. emphasize a better metabolic and glycolipidic control in patients with both DM1 and CD not following a GFD and suggest a protective role of CD in the prothrombotic state of DM1. In our opinion, their study has three critical points. First, all patients presented a glycosylated hemoglobin level (HbA1c)\7.5%. These inclusion criteria could be a selection bias that could influence the results. Second, in accord with literature, we believe that a single variable (glycosylated hemoglobin) is not sufficient to evaluate glycemic control: daily insulin dosages, hypoglycemia frequency, and glycemic variability should be also considered. Glycemic variability, specially, is considered an independent risk factor for complications [2]. Third, they do not analyze the effect of CD on the anthropometric variables nor investigate the presence of other autoimmunities. We followed up 74 patients with diabetes to evaluate the prevalence of celiac disease (CD) in a cohort of children
Acta Diabetol DOI 10.1007/s00592-011-0316-7 Received: 13 July 2011 / Accepted: 28 July 2011 Springer-Verlag 2011
