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Anyone have Coeliac Disease and Type 2?

Discussion in 'Gluten-free Forum' started by pinkiepunksmummy, Nov 23, 2015.

  1. himtoo

    himtoo Type 1 · Well-Known Member
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    @AlexTreville
    the following 2 excerpts are from the celiac association.

    The link between type 1 diabetes mellitus and celiac disease was first established in the 1960s. The estimated prevalence of celiac disease in patients with type 1 diabetes is approximately 8%, and about 1% in the general population. Most patients with both conditions have asymptomatic celiac disease, or symptoms that may be confused for symptoms of their diabetes.

    There is no established link between type 2 diabetes and celiac disease. Type 2 diabetes does have genetic components, but they are not associated with celiac disease genes like type 2 diabetes’ are.

    the original OP has clearly stated she is type 2 and to be honest this forum is about support , but support that is delivered in an empathetic way to encourage either further discussion or clearly engagement on the subject being discussed.
    Many people that post are scared , worried and very unsure when they post so kindness does make a difference to people.
     
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  2. Robinredbreast

    Robinredbreast Type 1 · Oracle

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  3. Indy51

    Indy51 Type 2 · Expert

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    @pinkiepunksmummy - there is also a condition called "non-celiac gluten sensitivity" although there are some researchers who believe this to be a form of FODMAPS intolerance (wheat is a FODMAPS food) - there is quite a lot of current research being done in this area. Since you said you also have IBS, you might want to check out the low FODMAPS diet to see if it helps you:

    http://www.med.monash.edu/cecs/gastro/fodmap/
     
  4. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    @AlexTreville , this is your quote :- Coeliac basically guarantees Diabetes...from reading on the web; about 10% of Type 1 Diabetics are Coeliac as well. I was diagnosed with Type 2 Diabetes 3 years before I went off gluten after my niece was diagnosed, and I had the Red Cross check my Alleles, and came up positive for the genetics.

    Having coeliac doesn't basically guarantee coeliac and having diabetes doesn't basically guarantee coeliac either.. Type 1 diabetes accounts for about 10 % , so with your quote that would mean all type 1's have coeliac, which they don't.
    I found a good link about coeliac myths.
     
  5. pinkiepunksmummy

    pinkiepunksmummy Type 2 · Active Member

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    Well, it turns out that I don't have Coeliac's Disease, but I do have an egg allergy, Mast Cell Activation and possibly Crohn's or Collitis, still waiting for further testing on those.
    I finally got skin prick testing and have had lots of my allergies confirmed.
    I started on Nalcrom food allergy tablets which are reducing my allergic reactions and my skin and stomach have settled down a bit.
    Managing a healthy diet and diabetes is hard when whole food groups have to be cut out due to allergies - all fish and shellfish, all fruits, some vegetables and now eggs too :( I am glad I can still eat gluten/wheat!
     
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  6. Tony337

    Tony337 Type 1 · Well-Known Member

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    Hello
    New member here.
    Type 1 for 42 years and a coeliac for 7.

    Phew a complex discussion.............

    I just wanted to point out that people are sometimes mis-diagnosed with IBS when they actually have Bile Acid Malabsorption.
    Not trying to depress you as it is treatable.

    Kindest regards and good luck

    Tony
     
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  7. Contralto

    Contralto Type 2 · Expert

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    Actually, I am interested in how you were finally diagnosed with Bile Acid Malabsorption . Were there particular tests? Maybe it is possible to have IBS plus this malabsorption? And could you talk a little about it?
     
  8. Tony337

    Tony337 Type 1 · Well-Known Member

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    I was suffering with bad guts for quite a while so went to the Doctors.
    After tests i had a camera down my throat (shocking experience) and coeliacs was dignosed.
    Following a gluten free diet didn't cure my bad guts so other tests for allergies and the like followed.
    All of this took about 2 years so you can imagine my state of mind (discussing bad guts with friends and family is not the done thing).
    I was then sent for a Nuclear test which is quite simple but apparently expensive(!)
    Took a large tablet then a scan was taken of my guts.
    Went back a week later for the same scan and from this Bile Acid Malabsorption was diagnosed which simply put means my liver doesn't deal with acid properly so it dumps it in my intestines causing the bad guts!
    I was given some powders which didn't suit or work and then after some research i discovered a tablet called colesevalem which my GP was happy to prescribe.
    These have helped and improved my condition but not cured me 100 %.

    Medical understanding states IBS is often misdiagnosed as Doctors are reluctant to send people for the Nuclear test.

    Please understand this is only my humble understanding of my experiences and I could be quite wrong.

    Regards
    Tony
     
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  9. Contralto

    Contralto Type 2 · Expert

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    Your understanding is way better than mine. I have had the upper endoscopy and colonoscopies many times and an MRA of the abdomen but never the nuclear thing.
     
  10. Tony337

    Tony337 Type 1 · Well-Known Member

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    The proper term is seHCAT scan but i prefer nuclear test as it sounds more dramatic and if i was a bit cleverer i'd post a link as there's plenty of information on the WWW so if you just google it?

    Good luck

    Tony
     
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  11. Contralto

    Contralto Type 2 · Expert

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    I looked it up and found something a little hard to understand (since wirtten for docs) but interesting mentioning even another test. Have not found the nuclear one yet:


    Tests aid diagnosis of an under-recognized disorder
    Bile acid malabsorption (BAM) has been associated with diarrhea for nearly 50 years, yet it remains an under-recognized and underdiagnosed cause of chronic diarrhea. It is estimated that BAM occurs in one-third of patients diagnosed with irritable bowel syndrome with diarrhea (IBS-D) and up to 50 percent of those with functional diarrhea. Even so, few gastroenterologists consider BAM in chronic diarrhea cases.

    Bile acids are synthesized in the liver primarily through the classical microsomal cholesterol 7α-hydroxylase (CYP7A1) pathway. They are conjugated with taurine and glycine in a series of steps and stored in the gallbladder until released into the small intestine where they solubilize dietary lipids.

    The great majority of bile acids are eventually reabsorbed by the distal ileum and returned to the liver for recycling. When they aren't reabsorbed into the enterohepatic circulation — due to ileal resection, Crohn's disease or disrupted feedback control of bile acid synthesis — they spill into the colon, causing watery stools, urgency and fecal incontinence.

    Michael Camilleri, M.D., of Mayo Clinic in Minnesota, says the main problem in evaluating for BAM is the limited availability of reliable diagnostic tests.

    "The gold standard is the 75 selenium homocholic acid taurine (SeHCAT) retention test, but it's not available in many countries, including the United States, where the isotope it uses hasn't been approved by the FDA," he notes.

    In the SeHCAT test, a radio-labeled homolog of a natural bile acid is administered orally and retention measured after seven days. The test is able to evaluate BAM with 80 to 90 percent sensitivity and 70 to 100 percent specificity.

    One alternative to SeHCAT is a therapeutic trial of a bile sequestrant, such as cholestyramine, colestipol or colesevelam, which binds to bile acids in the gut. If symptoms improve, the response is seen as indirect proof of BAM. But some drugs, especially cholestyramine, are often poorly tolerated and not recommended for use without a definitive diagnosis. As a result, other tests for diagnosing bile acid malabsorption are being developed and validated.

    One involves the measurement of serum levels of the marker 7α-hydroxy-4-cholesten-3-one (C4) — a measure of bile acid synthesis. In head-to-head comparisons with the SeHCAT retention test, increased serum C4 had a sensitivity of 90 percent and specificity of 79 percent in diagnosing bile acid malabsorption. The test is noninvasive, requiring only a blood sample from patients, and is relatively inexpensive. "It's wonderful to be able to screen for bile acid malabsorption with a serum test. It was not developed at Mayo, but we have continued to validate and perfect the assays, proving that it's a useful test," Dr. Camilleri says.

    A paper describing Mayo's development of a serum C4 assay appeared in the March 2009 issue of Neurogastroenterology & Motility.

    Bile acid excretion test
    Another option is a total bile acid excretion test based on quantification of bile acids in a 48-hour stool collection. The bile acid test can be run on the same sample used for a fecal fat excretion test, and the assay using high-performance liquid chromatography and mass spectrometry is extremely accurate. "The proportions of the primary and secondary bile acids are determined on the same sample, and it is especially important to assess the proportion of the secretory bile acids, mainly deoxycholic acid and chenodeoxycholic acid, in the stool sample," Dr. Camilleri explains.

    The fecal bile acid excretion test will likely have multiple uses, including evaluation of Crohn's disease patients with diarrhea, especially after ileal resection or when diarrhea persists after inflammation has been controlled. The test will be available through Mayo Medical Laboratories by mid-2014.

    "We've broken the ice and conclusively demonstrated that a large subgroup of patients with chronic diarrhea needs to be diagnosed properly and treated more specifically and effectively with bile sequestrants," Dr. Camilleri says, adding, "Welchol is a newer drug that is FDA-approved for hypercholesterolemia and as an adjunct treatment for type 2 diabetes. It comes in a tablet form, so medication compliance is likely to be better than with cholestyramine."

    He notes that in the future a more targeted therapy, such as a class of medications called farnesoid X receptor agonists, may become available and increase the feedback inhibition of bile acid synthesis.

    For more information
    Camilleri M, et al. Measurement of serum 7α-hydroxy-4-cholesten-3-one (or 7αC4), a surrogate test for bile acid malabsorption in health, ileal disease and irritable bowel syndrome using liquid chromatography-tandem mass spectrometry. Neurogastroenterology & Motility. 2009;21:734.
     
  12. Tony337

    Tony337 Type 1 · Well-Known Member

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  13. MCMAHOS

    MCMAHOS · Newbie

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    You do not have to eat sugary carbs on a gluten free diet, I am Coeliac, I do not eat cakes, biscuits etc and I do not like gluten free bread. Just remember that all meat, fish and veg are gluten free until interfered with so cook them yourself and you will be ok. I have just been told that I am pre diabetic , I think the only thing I can do to help myself is more exercise and cut out potatoes
     
  14. littlelin

    littlelin Type 2 · Well-Known Member

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    hello pinkiepunks mummy you have been through the wars with your allergies.
    life does improve once you know the status quo and manage your diet, however strict you have to be. It will be worth it. Keep going.
    I have been labelled a Coeliac since losing weight to under the 5stone mark in 1983 and lived on almost nothing at that time. GP didnt know of anything to prescribe I was the first in the area!
    Life for coeliacs is very different now thankfully.
    However whilst pretty immobolised in 2009 waiting for a replacement knee my weight went up and hey presto I slipped into the diabetic label too. All ok now though feel good and coping well but guess who is taking away the lifelines for people like us.... NHS no more test strips and No basic GF on prescription.
    Why?? I,m told because I havent needed a gp appointment and have managed myself!!
    Onwards and upwards!
     
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  15. Mana1

    Mana1 · Member

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    My husband was diagnosed type 2 2months ago and coeliac all his life but diagnosed 1994 he is currently on lchf diet but is struggling with loose bowls he has a pain then has to run. Not ideal when your walking for 1-2 hrs a day. Can anybody advise please as this is getting him down his has no confidence in going any distance.
     
  16. Indy51

    Indy51 Type 2 · Expert

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    Is he taking metformin? It can cause gastric distress.
     
  17. Mana1

    Mana1 · Member

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    no meds just controlling with diet & exercise.
     
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