Type 1 Diabetes and Gluten Intake

Öz

Type 1 diabetes is a chronical disease which comes along with dependence on insulin lifelong. Such incidence appears due to pancreatic beta cells’ immune-mediated destruction. It has been reported that, alongside the genetic factors, environmental factors are also important. Recently, among newly diagnosed patients, incidence of type diabetes has increased. Meanwhile, there is a decrease in the prevalence of high-risk HLA haplotypes. This situation coincides with increasing factors such as the use of antibiotics, the popularity of low fiber intake, and a high intake of gluten, suggesting that environmental factors may potentiate autoimmunity in beta cells. Gluten is a storage protein. And it is found in wheat, rye and barley. The hypothesis is that, gluten may be affective on immune cell populations and profile of cytokine, therefore lead to gut microbiota’s dysbiosis. Gluten may also have effects such as being immunogenic and activating the autoimmune response. Studies are done. And some of them has shown that gluten intake increases the risk of type 1 diabetes as well as no effect, and it has been suggested that gluten exposure during fetal life and the time of first exposure to gluten may be a factor. In studies on gluten-free diet, results such as better glycemic control and reduction in hypoglycemia attacks have been obtained and it has been considered that gluten-free diet may be protective. Although there are inferences that high gluten intake is related to a rise in the risk of type 1 diabetes, it has also been observed that there are some opposite inferences. This review article has been prepared by reviewing the national and international literature within the last six years and it was aimed to evaluate the possible mechanisms and effects of gluten in the development of type 1 diabetes.

Anahtar Kelimeler

• type 1 diabetes
• gluten
• islet autoimmunity

Kaynakça

1. Lund-Blix, N. A., Dong, F., Mårild, K., Seifert, J., Barón, A. E., Waugh, K. C., Joner, G., Størdal, K., Tapia, G., Stene, L. C., Johnson, R. K., Rewers, M. J., & Norris, J. M. (2019). Gluten Intake and Risk of Islet Autoimmunity and Progression to Type 1 Diabetes in Children at Increased Risk of the Disease: The Diabetes Autoimmunity Study in the Young (DAISY). Diabetes care, 42(5), 789–796. https://doi.org/10.2337/dc18-2315
2. Haupt-Jorgensen, M., Holm, L. J., Josefsen, K., & Buschard, K. (2018). Possible Prevention of Diabetes with a Gluten-Free Diet. Nutrients, 10(11), 1746. https://doi.org/10.3390/nu10111746
3. Johnson, R. K., Tamura, R., Frank, N., Uusitalo, U., Yang, J., Niinistö, S., Andrén Aronsson, C., Ziegler, A. G., Hagopian, W., Rewers, M., Toppari, J., Akolkar, B., Krischer, J., Virtanen, S. M., Norris, J. M., & TEDDY Study Group (2021). Maternal food consumption during late pregnancy and offspring risk of islet autoimmunity and type 1 diabetes. Diabetologia, 64(7), 1604–1612. https://doi.org/10.1007/s00125-021-05446-y
4. Buschard K. (2022). The etiology and pathogenesis of type 1 diabetes - A personal, non-systematic review of possible causes, and interventions. Frontiers in endocrinology, 13, 876470. https://doi.org/10.3389/fendo.2022.876470
5. Giwa, A. M., Ahmed, R., Omidian, Z., Majety, N., Karakus, K. E., Omer, S. M., Donner, T., & Hamad, A. R. A. (2020). Current understandings of the pathogenesis of type 1 diabetes: Genetics to environment. World journal of diabetes, 11(1), 13–25. https://doi.org/10.4239/wjd.v11.i1.13
6. Troncone, A., Affuso, G., Cascella, C., Chianese, A., Pizzini, B., Zanfardino, A., Iafusco, D., & Diabetes Study Group of Italian Society of Paediatric Endocrinology and Diabetology (2022). Prevalence of disordered eating behaviors in adolescents with type 1 diabetes: Results of multicenter Italian nationwide study. The International journal of eating disorders, 55(8), 1108–1119. https://doi.org/10.1002/eat.23764
7. Toni, G., Berioli, M. G., Cerquiglini, L., Ceccarini, G., Grohmann, U., Principi, N., & Esposito, S. (2017). Eating Disorders and Disordered Eating Symptoms in Adolescents with Type 1 Diabetes. Nutrients, 9(8), 906. https://doi.org/10.3390/nu9080906
8. Antvorskov, J. C., Halldorsson, T. I., Josefsen, K., Svensson, J., Granström, C., Roep, B. O., Olesen, T. H., Hrolfsdottir, L., Buschard, K., & Olsen, S. F. (2018). Association between maternal gluten intake and type 1 diabetes in offspring: national prospective cohort study in Denmark. BMJ (Clinical research ed.), 362, k3547. https://doi.org/10.1136/bmj.k3547

9. Gorelick, J., Yarmolinsky, L., Budovsky, A., Khalfin, B., Klein, J. D., Pinchasov, Y., Bushuev, M. A., Rudchenko, T., & Ben-Shabat, S. (2017). The Impact of Diet Wheat Source on the Onset of Type 1 Diabetes Mellitus-Lessons Learned from the Non-Obese Diabetic (NOD) Mouse Model. Nutrients, 9(5), 482. https://doi.org/10.3390/nu9050482
10. Haupt-Jorgensen, M., Nielsen, E., Engkilde, K., Lerche, M., Larsen, J., & Buschard, K. (2017). Occupation with grain crops is associated with lower type 1 diabetes incidence: Registry-based case-control study. PloS one, 12(7), e0181143. https://doi.org/10.1371/journal.pone.0181143
11. Norris, J. M., Johnson, R. K., & Stene, L. C. (2020). Type 1 diabetes-early life origins and changing epidemiology. The lancet. Diabetes & endocrinology, 8(3), 226–238. https://doi.org/10.1016/S2213-8587(19)30412-7
12. Passali, M., Josefsen, K., Frederiksen, J. L., & Antvorskov, J. C. (2020). Current Evidence on the Efficacy of Gluten-Free Diets in Multiple Sclerosis, Psoriasis, Type 1 Diabetes and Autoimmune Thyroid Diseases. Nutrients, 12(8), 2316. https://doi.org/10.3390/nu12082316
13. Antvorskov, J. C., Halldorsson, T. I., Josefsen, K., Svensson, J., Granström, C., Roep, B. O., Olesen, T. H., Hrolfsdottir, L., Buschard, K., & Olsen, S. F. (2018). Association between maternal gluten intake and type 1 diabetes in offspring: national prospective cohort study in Denmark. BMJ (Clinical research ed.), 362, k3547. https://doi.org/10.1136/bmj.k3547
14. Söderström, H., Cervin, M., Dereke, J., Hillman, M., Tiberg, I., Norström, F., & Carlsson, A. (2022). Does a gluten-free diet lead to better glycemic control in children with type 1 diabetes? Results from a feasibility study and recommendations for future trials. Contemporary clinical trials communications, 26, 100893. https://doi.org/10.1016/j.conctc.2022.100893
15. Goodwin G. (2019). Type 1 Diabetes Mellitus and Celiac Disease: Distinct Autoimmune Disorders That Share Common Pathogenic Mechanisms. Hormone research in paediatrics, 92(5), 285–292. https://doi.org/10.1159/000503142
16. Sargin, P., Roethle, M. F., Jia, S., Pant, T., Ciecko, A. E., Atkinson, S. N., Salzman, N. H., Teng, R. J., Chen, Y. G., Cabrera, S. M., & Hessner, M. J. (2022). Lactiplantibacillus plantarum 299v supplementation modulates β-cell ER stress and antioxidative defense pathways and prevents type 1 diabetes in gluten-free BioBreeding rats. Gut microbes, 14(1), 2136467. https://doi.org/10.1080/19490976.2022.2136467
17. Hakola, L., Miettinen, M. E., Syrjälä, E., Åkerlund, M., Takkinen, H. M., Korhonen, T. E., Ahonen, S., Ilonen, J., Toppari, J., Veijola, R., Nevalainen, J., Knip, M., & Virtanen, S. M. (2019). Association of Cereal, Gluten, and Dietary Fiber Intake With Islet Autoimmunity and Type 1 Diabetes. JAMA pediatrics, 173(10), 953–960. https://doi.org/10.1001/jamapediatrics.2019.2564
18. Lund-Blix, N. A., Tapia, G., Mårild, K., Brantsaeter, A. L., Njølstad, P. R., Joner, G., Skrivarhaug, T., Størdal, K., & Stene, L. C. (2020). Maternal and child gluten intake and association with type 1 diabetes: The Norwegian Mother and Child Cohort Study. PLoS medicine, 17(3), e1003032. https://doi.org/10.1371/journal.pmed.1003032
19. Kaur, P., Agarwala, A., Makharia, G., Bhatnagar, S., & Tandon, N. (2020). EFFECT OF GLUTEN-FREE DIET ON METABOLIC CONTROL AND ANTHROPOMETRIC PARAMETERS IN TYPE 1 DIABETES WITH SUBCLINICAL CELIAC DISEASE: A RANDOMIZED CONTROLLED TRIAL. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 26(6), 660–667. https://doi.org/10.4158/EP-2019-0479
20. Neuman, V., Pruhova, S., Kulich, M., Kolouskova, S., Vosahlo, J., Romanova, M., Petruzelkova, L., Obermannova, B., Funda, D. P., Cinek, O., & Sumnik, Z. (2020). Gluten-free diet in children with recent-onset type 1 diabetes: A 12-month intervention trial. Diabetes, obesity & metabolism, 22(5), 866–872. https://doi.org/10.1111/dom.13974
21. Burayzat, S., Elsahoryi, N., Freitekh, A., Alzoubi, O., Al-Najjar, R., & Tayyem, R. (2022). Does a Gluten-Free Diet Affect BMI and Glycosylated Hemoglobin in Children and Adolescents with Type 1 Diabetes and Asymptomatic Celiac Disease? A Meta-Analysis and Systematic Review. Children (Basel, Switzerland), 9(8), 1247. https://doi.org/10.3390/children9081247
22. Haupt-Jorgensen, M., Larsen, J., Josefsen, K., Jørgensen, T. Z., Antvorskov, J. C., Hansen, A. K., & Buschard, K. (2018). Gluten-free diet during pregnancy alleviates signs of diabetes and celiac disease in NOD mouse offspring. Diabetes/metabolism research and reviews, 34(4), e2987. https://doi.org/10.1002/dmrr.2987
23. Infante, M., Ricordi, C., Sanchez, J., Clare-Salzler, M. J., Padilla, N., Fuenmayor, V., Chavez, C., Alvarez, A., Baidal, D., Alejandro, R., Caprio, M., & Fabbri, A. (2019). Influence of Vitamin D on Islet Autoimmunity and Beta-Cell Function in Type 1 Diabetes. Nutrients, 11(9), 2185. https://doi.org/10.3390/nu11092185 Çarkçı, N. Ş., Özsoy, S. A. (2020). İzmir İlinde Takip Edilen Tip 1 Diyabetli Çocukların Epidemiyolojik Özelliklerinin İncelenmesi. KOÇ ÜNİVERSİTESİ HEMŞİRELİKTE EĞİTİM VE ARAŞTIRMA DERGİSİ, 17(1):24-31 doi:10.5222/HEAD.2020.024
24. DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018). Type 1 diabetes. Lancet (London, England), 391(10138), 2449–2462. https://doi.org/10.1016/S0140-6736(18)31320-5
25. Atik Altınok, Y., & Gökşen, D. (2020). Tip 1 Diyabet ve Çölyak Hastalığı Birlikteliği: Olgu Sunumu. Beslenme ve Diyet Dergisi, 48(3), 119–125. https://doi.org/10.33076/2020.BDD.1431 Özkan, N., Kurtbeyoğlu, E., Aslan Gönül, B., & Caferoğlu, Z. (2022). Tip 1 Diyabet, Çölyak ve Besin Alerjisi Birlikteliğinde Tıbbi Beslenme Tedavisi: Pediatrik Olgu Sunumu. Beslenme ve Diyet Dergisi, 50(2), 110–117. https://doi.org/10.33076/2022.BDD.1651
26. Ertem, G. S., Ergün, S., Özyazıcıoğlu, N. (2021). Tip 1 Diyabetli Çocuk ve Adölesanlarda Metabolik Kontrol. YOBU Sağlık Bilimleri Fakültesi Dergisi. YOBU Sağlık Bilimleri Fakültesi Dergisi, 2(1):28-37
27. Kutlu, T. (2019). Gluten-free diet: is it really always beneficial? Turk Pediatri Ars, 54(2): 73–7. DOI: 10.14744/TurkPediatriArs.2019.82609
28. Ulusoy, H. G., & Rakıcıoğlu, N. (2019). Glutensiz Diyetin Sağlık Üzerine Etkileri. Beslenme ve Diyet Dergisi, 47(2), 87–92. https://doi.org/10.33076/2019.BDD.1026
29. Yau, M., Maclaren, N. K., Sperling, M. A. Etiology and Pathogenesis of Diabetes Mellitus in Children and Adolescents. 2021 Jun 19. In: Feingold, K. R., Anawalt, B., Boyce, A., Chrousos, G., De Herder, W. W., Dhatariya, K., Dungan, K., Hershman, J. M., Hofland, J., Kalra, S., Kaltsas, G., Koch, C., Kopp, P., Korbonits, M., Kovacs, C. S., Kuohung, W., Laferrère, B., Levy, M., McGee, E. A., McLachlan, R., Morley, J. E., New, M., Purnell, J., Sahay, R., Singer, F., Sperling, M. A., Stratakis, C. A., Trence, D. L., Wilson, D. P, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000–. PMID: 29714936
30. Sapra, A., Bhandari, P., Wilhite (Hughes), A. Diabetes Mellitus (Nursing). [Updated 2022 Jun 26]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
31. Neuman, V., Pruhova, S., Kulich, M., Kolouskova, S., Vosahlo, J., Romanova, M., Petruzelkova, L., Havlik, J., Mascellani, A., Henke, S., Sumnik, Z., & Cinek, O. (2023). Changes in the gut bacteriome upon gluten-free diet intervention do not mediate beta cell preservation. Diabetologia, 66(1), 241–246. https://doi.org/10.1007/s00125-022-05805-3