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People With Celiac Disease Are Less Likely To Develop Type 2 Diabetes

Needle_VialIf you have celiac disease, you may have heard that you are at increased risk for type 1 diabetes. An association between type 1 diabetes and celiac disease has been known for quite some time. Both are both autoimmune disorders. In the case of type 1 diabetes, the body destroys cells in the pancreas that make insulin. Insulin is needed by the body in order to metabolize sugar (glucose) properly, and to regulate the amount of sugar in the blood.

Type 2 diabetes is different from type 1 in a number of ways. It’s caused because cells are relatively resistant to the effects of insulin, which is why it can also be called non-insulin-dependent diabetes mellitus (NIDDM). It tends to come on at a later age, and is frequently associated with obesity. Eventually, people with type 2 diabetes may need to be treated with insulin, but at the beginning diet and oral medication are used.

Somewhat surprisingly, a recent study determined that people with celiac disease are much less likely to develop type 2 diabetes than people without CD, which is the reverse of the situation with type 1 diabetes.

The study looked at 840 adults with celiac disease proven by biopsy. They were then matched with a group of people similar in age, sex, and ethnicity who did not have celiac disease.

In the control group (those without celiac disease), 9.6% of the people were found to have type 2 diabetes. Only 3.1% of the people with celiac disease had type 2 diabetes.

This type of diabetes is associated with obesity, so the researchers tried to determine if the difference in the rates of diabetes between the two groups was because of differences in weights. The participants with celiac disease did have lower weights and lower BMIs (Body Mass Index, another indicator of obesity). Even after analyzing the data and adjusting for weight, the people with celiac disease were statistically significantly less likely to have type 2 diabetes.

The researchers also compared the amount of diabetes in the group with CD to the rates of type 2 diabetes in the general population of the United States. This has been determined by the National Health and Nutrition Examination Survey (NHANES), and is 9.8%. The patients with celiac disease had one third this rate.

There is also a condition called “the metabolic syndrome” which increases a person’s risk of heart disease and stroke. It refers to a number of abnormalities occurring together, including:

– Abdominal obesity – fat which is concentrated in the middle of the body at the waistline
– Elevated fasting blood sugar (blood sugar in the morning before eating)
– Low HDL, or “good” cholesterol
– High triglycerides, another type of fat measured in the blood
– High blood pressure

A person must have three of these abnormalities to be diagnosed with the metabolic syndrome. They are at higher risk for developing type 2 diabetes.

Study participants in both groups were checked for this syndrome. A smaller percent of people with celiac disease had the metabolic syndrome than in the control group.

The study was not designed to try and figure out why people with celiac disease might have less diabetes. The authors suggested that it might have to do with changes in the functioning of the pancreas, decreased absorption of nutrients, or alterations in certain chemicals and hormones regulating inflammation that might cause the lower risk.

Further studies are needed to shed more light on these finding.

So, it seems that there’s a silver lining in the “cloud” of celiac disease. If you’re an adult who has celiac disease already and haven’t been diagnosed with diabetes (type 1 diabetes comes on earlier in life), there appears to be less chance you will develop it than if you did not have celiac disease.

Reference
Kabbani T.A., Kelly C.P., Betensky R. A., et al. Patients With Celiac Disease Have a Lower Prevalence of Non–Insulin-Dependent Diabetes Mellitus and Metabolic Syndrome. Gastroenterology. Volume 144, Issue 5 , Pages 912-917.e1, May 2013.
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