Ask The Doctor
On January 9, 2007, we were excited to be featured along with University of Kentucky gastroenterologist Dr. Razvan Arsenescu on WKYT TV's local Noon News. We are equally excited to be partnering with Dr Arsenescu in order to bring you our regular web site feature, Ask The Doctor. Here we provide a channel directly to Dr.Arsenescu for your questions regarding gluten-related disorders and the gluten free diet.
Click here to submit your question via email. Your question will be promptly forwarded to Dr. Arsenescu, and his answer will be returned to you as soon as administratively possible.
Dr. Arsenescu is happy to collaborate with your current physician - you do not need to switch doctors. To learn more about Dr. Arsenescu, simply click on his name above.
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News & Views
by Razvan Arsenescu, M.D.
Celiac Sprue Screening In Children With Type 1 Diabetes
Diagnosing celiac sprue (CD) in asymptomatic individuals remains a controversial issue, but mounting evidence indicates a benefit for those in at-risk groups. A current study by Jill H. Simmons1 evaluated children with type 1 diabetes and celiac autoimmunity. It was concluded that these diabetic children with positive serology for CD have decreased weight and body mass index compared to those who tested negative. Although their bone density scores were no different, certain laboratory markers suggested a risk for future alteration in bone mineralization. Whether these findings will translate into abnormal growth by the time of adulthood, is unknown. The outcome for children with biopsy-proven CD was not significantly different from those with serologic test alone.
There were certain limitations of this study: the number of patients, lack of gluten free diet standardization, and limitations of CD diagnostic work-up. Although the study is not definitive and does not serve as a guideline, CD screening in at-risk children should be discussed with a pediatrician. We should also raise awareness of the misleading term "asymptomatic individuals". Too many times this term is used to refer only to gastrointestinal complaints, which only represent the tip of the "celiac iceberg".
1The Journal of Pediatrics. Volume 150, Issue 5, May 2007, pp. 461-466.