Diabetes and celiac

[draperygoddess]

I'm wondering if there has been a discussion about this in the past: my daughter and I were talking this morning about the possible ramifications of my genetic testing, and she wanted to look up the genes. In the article we read, we found that the same genes (DQ2 & DQ8) that predispose for celiac disease also predispose for diabetes. This is huge for my family, because my dad, his brother, and his mother were all insulin-dependent diabetics. One of my father's difficulties has always been controlling his weight. A number of years ago I went on South Beach to lose some post-pregnancy weight, and it was very effective for me (until I started eating like a normal person again, that is!). Since going GF, I have lost 7 or 8 pounds (ones that I could afford to lose) and am having no trouble maintaining my weight, though I continue to eat sugar and carbs that are not wheat (rice, anyone?). I am wondering if my dad's "carb" problem might actually be a GLUTEN problem. Does anyone else have some insight? I will see my family next week and hope I will have my lab results before then, but I would love to talk to my dad about trying a GF diet!

[sarkin]

Wow, Cynthia. I think you should start an "office pool" of betting on your Enterolab tests. Hopefully you could win, and collect some money for GF purchasing! (I'm ready to place a bet!)

I am a double-DQ2 gal. There's been no diabetes in my family, though my father always had some test that led to suspecting it (I think urine sugars were high, but not bloods?). An adult-onset Type-1 D friend had 2 of her 3 kids tested, and they were off the charts gluten-sensitive. She also did the gene tests, and her daughter had the same DQ2 '0201' gene that I have (officially classified celiac), and her son had the 0202 variant that happens to be my other gene.

My Type 1 friend was originally mis-Dx'd as Type 2, till she got herself into a really good program. I also have a young friend, diagnosed with Type 1 at 12, who has celiac genes and antibodies. But her diabetes program has assured them they don't have to pay attention to gluten.

We have in our family at least a couple of DQ8 folks with Type1... that's browse-able in this forum, in a thread about genetic test results. Kelly's daughter, and Denise, come to mind - but I wonder, is your dad Type 1 or 2? I'm sure if Tex has a better tracking method for genes & type 1/2, he will advise. (I am very concerned about a Type 2 neighbor whose husband has thrived on an anti-carb diet, but while her MIL was with them, she couldn't go along with him, though she feels much better when she does.)

And - my cousin-twin - I also do very well on lower-carb diets, I now realize. I have also lost some "affordable" weight since finding myself here - though at first I was dropping pounds much too fast, I'm now in a good weight range.

Hope your dad is curious, even if he's not immediately receptive.

xox/S

[draperygoddess]

Sara,

My dad is type 2. I realize that the genetic link to DQ2 is with type 1, but obviously there is a genetic factor to type 2 (hence the plethora of cases in my family). I'm wondering if there's a connection there with the gluten sensitivity.

I'm also curious about the whole heritage thing. From what I've read, DQ2 is found in the highest concentration in Northern Europe (which explains its prevalence in the US), while DQ8 is seen more in Asian and Native American populations. I will be interested to see what genes I inherited, since my dad has some Choctaw in his family. I read a study that stated that 97% of Native Americans carry the DQ8 gene. Eeenterresstiing.

[draperygoddess]

Hmmm.....I've been reading up on this in preparation for seeing my dad this weekend, and I've read several articles that refer to Type 1 merely as "insulin-dependent" and Type 2 as "non-insulin-dependent." I also saw some references to "ambiguous Type 1/2." I was under the impression that there was a totally different etiology for the two types. My uncle and grandmother were both diagnosed in their 50's or 60's and were both insulin-dependent (and I mean the "eat-every-three-hours-check-your-levels-5-times-a-day" type of insulin-dependent). My dad had hypoglycemia in his 30's, was diagnosed pre-diabetic in his 50's, and was told that eventually he would be insulin-dependent (I assume because, genetically speaking, he was a lost cause). He reached the point of needing insulin a couple of years ago, though he is not on nearly the regimen his mother and brother were. So does that make him Type 1 or Type 2?

I'm hoping that some of your who are diabetic and/or in the medical profession can shed some light on this for me!

[tex]

Cynthia,

I apologize, because I don't fit the qualifications that you listed, but IMO, your dad is almost surely a Type 2 diabetic. Here's why:

Type 1 diabetics aren't capable of producing insulin. With Type 1, the pancreas is usually damaged early on, by autoantibodies, and it loses the ability to produce insulin. Type 2 diabetics produce insulin, but their bodies are "resistant", so that eventually, they get to a point where they can no longer utilize enough of the insulin they produce, to meet their metabolic needs, even though an adequate amount might be available.

When you think back, wasn't your dad's condition described as "insulin-resistance", during the earlier stages?

Tex

[draperygoddess]

Tex,

That's what I thought, as well. I'm not sure if the term "insulin resistance" was ever used, but that definitely appears to be what happened: his pancreas kept cranking out more and more insulin to compensate for his resistance to it, and eventually it just wasn't enough. I'm not sure why there would be a question as to whether someone is Type 1 or Type 2, if that's the case. Even if you were older when you developed diabetes, it would surely be a sudden thing if it were Type 1, whereas Type 2 is more gradual.

I wonder why there is a significant correlation between DQ2 and Type 1, but a much weaker one for Type 2? (From what I read, it appears that the DQ2 connection is only significant for people diagnosed Type 2 at a relatively young age--before age 50.)

[tex]

I wonder why there is a significant correlation between DQ2 and Type 1, but a much weaker one for Type 2

Because, (IMO), the DQ2 gene is connected with autoimmune issues, and early onset of diabetes is a result of an autoimmune attack on the pancreas, which suggests that the gene may have been triggered, (is active). The earlier in life that the gene is triggered, the higher the odds of developing autoimmune issues, (simply because more time is available for the events to happen). In contrast, without the DQ2 gene, the odds of the development of autoimmune issues are reduced, and since Type 2 does not involve an autoimmune reaction, that suggests the lack of a connection with the DQ2 gene, (or at least a "weaker" connection).

Tex

[draperygoddess]

If Type 2 is not caused by an autoimmune reaction, what DOES cause it? Obviously there's a strong genetic component involved. What is it that makes some people insulin-resistant, wonder? It's almost like the autoimmune reaction in reverse: instead of reacting to something we shouldn't, we don't react to something we should. I wonder what would happen if my dad went on a GF diet instead of low carb?

[tex]

Well, it's blamed on lack of exercise, obesity, metabolic syndrome, and even pregnancy, or steroid use can cause it, but the fact of the matter is, apparently no one really knows what the mechanism that causes it, actually involves - all they know is that it's "associated" with the issues specified, but that doesn't define what actually causes it.

I'll tell you what, gluten-sensitivity not only inflames the mucosa of the intestines, but it also causes the brush border regions of the small intestine to stop producing certain enzymes, (such as lactose, which is the first to go), and it can affect virtually every organ in the body, in some cases. The inflammation caused by gluten-sensitivity can also cause bile salts to be malabsorbed, because, (IMO), the pancreatic enzymes fail to properly hydrolyze the fats, thus tying up the bile salts, and causing them to become unavailable for reabsorption in the terminal ileum. More than a few members have had pancreatic inflammation issues until they got their symptoms under control, so with all that chemical disruption going on, I can certainly see how gluten-sensitivity might somehow affect insulin resistance, because of corrupted chemical coding, caused by malfunctioning organs all over the body. It's certainly possible, IMO, that molecular mimicry might somehow be responsible for the inability of the body to utilize the insulin that is available to it. Maybe something about insulin resembles one of the peptides in gluten, that we react to. That would, of course, make insulin resistance an undiscovered autoimmune event.

IMO, If I were having diabetic issues, I would certainly give a GF diet a good long try. It can't hurt anything, so it's a risk-free treatment, with nothing to lose, and a lot to gain, if it should work.

Tex

[draperygoddess]

Makes sense. I have watched my blood sugar for years due to the family history. My grandmother was very active, never overweight, an avid gardener who ate lots of fresh vegetables--and she still became insulin-dependent. I have had hypoglycemic issues for years, but interestingly, when I went GF, they resolved, even though I'm still eating carbs and sugar. So it seems that, at least in my case, the blood sugar issue may have more to do with gluten than it does with carbs in general.

[tex]

I have had hypoglycemic issues for years, but interestingly, when I went GF, they resolved, even though I'm still eating carbs and sugar. So it seems that, at least in my case, the blood sugar issue may have more to do with gluten than it does with carbs in general.

That's a good observation.

Tex