Gluten-free diet may help complications of type I diabetes

Children with type 1 diabetes are at a higher risk of developing celiac disease, with approximately 4-8% of diabetic children being also diagnosed as celiacs. Celiac disease requires a completely gluten-free diet, so modern management practices include elimination of gluten from the diet in diabetic children.
A recent study by Dr. Malalasekera and collaborators (from the Department of Endocrinology and Diabetes, Royal Children’s Hospital in Melbourne, Australia) has shown that, while this is effective in reducing the symptoms and long-term complications of celiac disease, a gluten-free diet can also have a positive impact on diabetic complications.

Hyperglycemia is still considered the main cause of major diabetes complications. When excess glucose settles into the cells it forms sugar-derived substances called AGEs (advanced glycation end products), which can play a role in diabetic kidney disease. The formation of AGEs is accelerated in diabetes due to the higher availability of glucose, but AGEs also seem to be acquired from the diet.

Dr. Malalasekera and his collaborators then hypothesized that – since the gluten-free diet is low in high-temperature processed foods and in flour-based items (which are high in AGEs) – a gluten-free diet could lead to lower levels of AGEs in children with celiac disease and reduced kidney damage compared with matched diabetic patients without celiac disease.

Their analysis – which included 21 children with type 1 diabetes and celiac disease, and 38 individuals with diabetes alone – indeed showed that those diabetic children who also had celiac disease indeed had significantly lower blood levels of circulating AGEs, independently of metabolic control, diabetes management and other potentially confounding variables.

Replication of these findings, as well as their confirmation involving non-celiac diabetic patients following a gluten-free diet is required to determine whether the diet could be beneficial to non-celiac diabetics. Still, the results of this new study suggest that adherence to a gluten-free diet may provide additional benefits for diabetic children with celiac disease.

More information:  Malalasekera V, Cameron F, Grixti E, Thomas MC. 2009. Potential reno-protective effects of a gluten-free diet in type 1 diabetes. Diabetologia. 52(5):798-800.

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