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Al Hayek AA, Al Zahrani WM, AlAblani HM, Al Dawish MA. Metabolic control, adherence to the gluten-free diet and quality of life among patients with type 1 diabetes and celiac disease. Diabetol Metab Syndr 2023; 15:189. [PMID: 37759325 PMCID: PMC10536816 DOI: 10.1186/s13098-023-01167-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
AIMS In this cross-sectional study, we aimed to evaluate metabolic control, adherence to a gluten-free diet (GFD), and quality of life (QoL) in individuals with type 1 diabetes (T1D) and celiac disease (CD). METHODS We targeted individuals with T1D and CD at a major tertiary hospital in Saudi Arabia. We gathered retrospective data from medical records and prospectively assessed glycemic control using HbA1c and ambulatory glucose metrics, adherence to a GFD using the Celiac Dietary Adherence Test (CDAT), and QoL using the Celiac Disease Quality of Life survey (CD-QoL). RESULTS Forty-eight out of 1095 patients screened (4.38%) were included. Mean age and HbA1c were 21.3 (± 6.6) and 8.3% (± 0.8%). The average time in range% and above range% were 38.5 (range 24-68) and 29.6 (± 7.4). The median hypoglycemic events/month was 8, with a median duration of 80 min. The median overall CDAT and CD-QoL scores were 20.5 and 54. No significant correlations were observed between glucose management indicator (GMI), % in target, and CDAT/CD-QoL scores (all p > 0.05). CONCLUSIONS No significant effect of GFD on QoL or glycemic control was observed. Further prospective studies are warranted to establish solid evidence of the impact of GFD on individuals with T1D and CD.
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Affiliation(s)
- Ayman A Al Hayek
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia.
| | - Wael M Al Zahrani
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia
| | - Hamad M AlAblani
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia
| | - Mohamed A Al Dawish
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia
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Gluten-Free Diet in Co-Existent Celiac Disease and Type 1 Diabetes Mellitus: Is It Detrimental or Beneficial to Glycemic Control, Vascular Complications, and Quality of Life? Nutrients 2022; 15:nu15010199. [PMID: 36615856 PMCID: PMC9824312 DOI: 10.3390/nu15010199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Celiac disease (CeD) is associated with type 1 diabetes mellitus (T1DM), and both have the same genetic background. Most patients with T1DM who develop CeD are either asymptomatic or have mild CeD-related gastrointestinal symptoms. Therefore, children affected by T1DM should undergo screening for asymptomatic CeD. The aim of this review is to highlight the influence of a gluten-free diet (GFD) on glycemic control, growth rate, microvascular complications, and quality of life in patients with T1DM and CeD. PubMed, Google Scholar, Web of Science, and Cochrane Central databases were searched. Reports reviewed were those published from 1969 to 2022 that focused on the interplay of T1DM and CeD and examined the effect of diet on glycemic control, growth rate, and quality of life. The most challenging aspect for a child with T1DM and CeD is that most GFD foods have a high glycemic index, while low glycemic index foods are recommended for T1DM. Interestingly, dietary therapy for CeD could improve the elevated HbA1c levels. Avoiding gluten added to a diabetic dietary regimen in T1DM patients might impose practical limitations and lead to important restrictions in the lifestyle of a young patient. Consequently, non-adherence to GFD in patients with T1DM and CeD is common. GFD in patients with T1DM and CeD seems to lower the incidence of micro- and macrovascular complications, but this requires further investigation. It seems that adherence to GFD in young patients with T1DM and CeD leads to regular growth and a stable body mass index without any negative effect on HbA1c or insulin requirements. Furthermore, the lipid profile and quality of life seem to have improved with the introduction of GFD.
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Fröhlich-Reiterer E, Elbarbary NS, Simmons K, Buckingham B, Humayun KN, Johannsen J, Holl RW, Betz S, Mahmud FH. ISPAD Clinical Practice Consensus Guidelines 2022: Other complications and associated conditions in children and adolescents with type 1 diabetes. Pediatr Diabetes 2022; 23:1451-1467. [PMID: 36537532 DOI: 10.1111/pedi.13445] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Elke Fröhlich-Reiterer
- Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | | | - Kimber Simmons
- Barbara Davis Center for Diabetes, University of Colorado, Denver, Colorado, USA
| | - Bruce Buckingham
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University Medical Center, Stanford, California, USA
| | - Khadija N Humayun
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jesper Johannsen
- Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Herlev and Steno Diabetes Center Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Reinhard W Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - Shana Betz
- Parent/Advocate for people with diabetes, Markham, Canada
| | - Farid H Mahmud
- Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Kaur S, Kumar K, Singh L, Sharanagat VS, Nema PK, Mishra V, Bhushan B. Gluten-free grains: Importance, processing and its effect on quality of gluten-free products. Crit Rev Food Sci Nutr 2022; 64:1988-2015. [PMID: 36094456 DOI: 10.1080/10408398.2022.2119933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Gluten-enteropathy affects a significant number of people, making gluten a major concern in the food industry. With medical advancements, the diagnosis of allergies is becoming easier, and people who are allergic to gluten are recommended a complete gluten-free diet. Since wheat provides a major part of the energy and nutrition in the diet, its elimination affects nutrition intake of allergic population. Food scientists are working to formulate products using protein-rich gluten-free grains with quality attributes at par with gluten-containing products. Focused research has been done to provide nutrition and a variety of food to people suffering from gluten-related disorders. Efforts are being made to remove the gluten from the wheat and other gluten-containing grains, while applying different processing/treatments to enhance the properties of gluten-free grains. Hence, the present review summarizes the importance, processing, and products of different gluten-free grains. It also highlights the digestibility of gluten-free grains with clinical trials and gluten elimination strategies for gluten-containing grains.
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Affiliation(s)
- Samandeep Kaur
- Department of Food Engineering, National Institute of Food Technology Entrepreneurship and Management (NIFTEM), Sonepat, Haryana, India
| | - Kshitiz Kumar
- Department of Food Processing Technology, A. D. Patel Institute of Technology, Anand, Gujarat, India
| | - Lochan Singh
- Contract Research Organization, NIFTEM, Sonepat, Haryana, India
| | - Vijay Singh Sharanagat
- Department of Food Engineering, National Institute of Food Technology Entrepreneurship and Management (NIFTEM), Sonepat, Haryana, India
| | - Prabhat K Nema
- Department of Food Engineering, National Institute of Food Technology Entrepreneurship and Management (NIFTEM), Sonepat, Haryana, India
| | - Vijendra Mishra
- Department of Basics and Applied Sciences, National Institute of Food Technology Entrepreneurship and Management (NIFTEM), Sonepat, Haryana, India
| | - Bharat Bhushan
- Department of Basics and Applied Sciences, National Institute of Food Technology Entrepreneurship and Management (NIFTEM), Sonepat, Haryana, India
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FENG Y, WANG Q, HUA J, CAO H, LIU Y, ZHONG X, XIA Y, ZHANG F. A practical “low-carbohydrate dietary care” model for elderly patients with type 2 diabetes mellitus. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.77222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Yuwei FENG
- Jiangnan University, China; Jiangnan University, China
| | - Qinyue WANG
- Jiangnan University, China; Jiangnan University, China
| | - Jiao HUA
- Jiangnan University, China; Jiangnan University, China
| | - Hong CAO
- Jiangnan University, China; Jiangnan University, China; Jiangnan University, China; Jiangnan University, China
| | - Yiran LIU
- Jiangnan University, China; Jiangnan University, China
| | - Xiaohui ZHONG
- Jiangnan University, China; Jiangnan University, China
| | - Yanping XIA
- Jiangnan University, China; Jiangnan University, China
| | - Feng ZHANG
- Jiangnan University, China; Jiangnan University, China; Jiangnan University, China
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Rapaport R, Bloomgarden Z. Celiac disease: A global survey. J Diabetes 2021; 13:446-447. [PMID: 33715311 DOI: 10.1111/1753-0407.13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Use of Underexploited Flours for the Reduction of Glycaemic Index of Gluten-Free Biscuits: Physicochemical and Sensory Characterization. FOOD BIOPROCESS TECH 2021. [DOI: 10.1007/s11947-021-02650-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AbstractThe type and the amount of starch present in bakery products affect their glycaemic index. The control of glycaemic index in our diet can be relevant to reduce the risk of type 2 diabetes and heart diseases. The use of alternative flours to rice, maize, and their starches may improve the nutritional quality of gluten-free baked goods by reducing the glycaemic index. This work aimed at the formulation of satisfactory gluten-free biscuits by using underexploited flour mixes (from cereals, pseudocereals, and legumes), at the evaluation of their physical properties, starch digestibility and subsequent estimation of the glycaemic index. The presence of chickpea flour increased biscuit hardness and gluten-free flours darkened biscuit surface. The greatest differences in starch composition and its digestion were found between gluten-free samples and wheat-containing control. Experimental biscuits had also a lower predicted glycaemic index compared to commercial products, whereas experimental formulations presented similar values between each other. Consumers’ acceptance and sensory profiling by Check All That Apply questionnaire were carried out. All formulations but one were above the acceptance threshold (50); crumbliness and easiness to swallow were drivers of acceptance, whereas sandiness exerted a negative impact on liking score.
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