Friday, January 25, 2008


Following on the heels of the excellent video What You Need to Know about Celiac Disease and the Gluten-Free Diet, University of California Television (UCTV) now offers "Diabetes and the Gastrointestinal Tract," part of a book tie-in series called Taking Control of Your Diabetes.

The commercially supported video, featuring host Dr. Steven Edelman and guest Dr. James Wolosin, offers some basics about the gastrointestinal (GI) system and some GI conditions that are more likely to affect people who have diabetes.

Following a discussion about heartburn, acid reflux, and endoscopies, the conversation moves on to gastroparesis (around the 8:00 mark) and then celiac disease (around the 11:00 mark).

As the video states, people with Type 1 diabetes are more likely than the general population to have celiac disease; the same goes for people with first-degree relatives who have been diagnosed with celiac disease. (Even if you have a different type of diabetes, there's probably about a 1% chance of having undiagnosed celiac disease.)

Around the 14:40 mark there's a segment where a woman with diabetes raves about Whole Foods and talks about how her gastroparesis (delayed gastric emptying) went away after she adopted a gluten-free diet. (Heartburn also can go away after someone with celiac disease goes gluten-free.)

The coverage seems largely sound to me except for Dr. Wolosin's remarks differentiating people with celiac disease who show extreme sensitivity to gluten and people who do not show symptoms, saying that some people in the latter group can cheat a little bit on their diets every once in a while. Basically, almost all people with celiac disease who follow a gluten-free diet are likely to be accidentally contaminated every now and then (see my own confession, for instance), so it's probably not a great idea to compound the problem by giving patients a license to cheat intentionally, especially when damage to the body (such as bones and the intestines) can occur long before being noticed through symptoms. Cheating on the diet every now and then, like smoking every now and then, isn't likely to kill anyone, but it's still not the kind of thing I like to hear a doctor advocating.

As the video continues, the doctors also discuss ulcers, fatty liver, and colon cancer screening. The video ends with a summary.

Source (28:29)

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