Mark and I got into a bit of a ... debate about whether Bisi should go gluten-free. I pointed out that she wasn't even in a honeymoon period, and that the
story of one boy in Denmark wasn't enough reason to make her diet even more restricted than it already was. Also, all of our lives were already going
through such huge changes. We hadn't even perfected the basics of how to carb count or cook for our newly diabetic daughter. How could we pile something as
complicated as going gluten-free on top of it? Realistically, how could I take on the gluten-free cooking--since I'm the one who does 98% of it.
Mark did some more research, but the picture didn't become much clearer. There is no clear link between gluten and diabetes, but there are some hints of a
connection. Ten percent of people with T1D also have celiac disease -- an intolerance to the gluten in wheat (Bisi tested negative for celiac). In 2009, an
article in Diabetes magazine reported on a Canadian study indicating that "wheat can cause problems other than celiac in people with type 1
diabetes": "Canadian researchers who studied 42 people with type 1 found that nearly half had an abnormal immune response to wheat proteins, while none of
the 22 participants without diabetes had such a reaction. When the researchers looked for a genetic cause of the immune cell overreaction, they found that
it was linked to a gene associated with T1D -- but not related to a gene associated with celiac disease. According to the study's authors, people
with certain genes may be more likely to have an exaggerated immune reaction to foods like wheat, and this may spur other immune problems, like diabetes."
Another study from 2009, published in Diabetes , found that
"Mounting evidence suggests that the gut immune system is involved in the development of autoimmune diabetes. An inflammatory state has been demonstrated
to be present in the structurally normal intestine of patients with T1D, and the abnormal intestinal permeability that has been found in these
patients could represent a contributing factor."
Essentially, the thinking is that people with T1D have different intestinal flora than those without (the thinking is similar for other
conditions, including colic in babies and autism), and that their guts are more permeable. And Mark's thinking (again, some research backs him up on this,
and some doesn't) is that gluten is part of what has damaged Bisi's gut, or microbiome, and that perhaps the increased permeability has affected her
absorption of sugars and overtaxed her pancreas.
So, after talking all this over, Mark and I decided that we would try Bisi on the gluten-free diet (Mark has gone gluten-free in solidarity, and because he
has psoriasis, an autoimmune disease associated with diabetes and also with differences in the microbiome). We would hope that Bisi would enter a
honeymoon period, where her pancreas would start to produce some insulin again. And if she did, we would hope that we could extend her honeymoon.