Diabetes Mellitus, Type 1 Clinical Trial
Official title:
The Effect of Gluten-free Diet on Upper Gastrointestinal Symptoms in Type 1 Diabetic Patients With Dyspepsia-like Symptoms
Patients with type-1 diabetes are more susceptible to motility-related upper gastrointestinal symptoms. Dietary interventions are one of the treatment pillars for these symptoms. Many gastrointestinal conditions other than celiac disease, are being increasingly treated with gluten-free diet (GFD). The role of GFD in non-celiac type-1 diabetic patients with dyspepsia-like symptoms has not been assessed before. In this study, type 1 diabetes patients with concomitant upper gastrointestinal symptoms will be asked to follow a 1-month GFD to assess changes in upper gastrointestinal symptoms and gastroduodenal motility before and after the dietary intervention.
Diabetes mellitus (DM) is a complex and heterogeneous disease that is associated with poor
outcomes. In studies from referral centers, 50-65% of diabetics reported dyspeptic symptoms.
In addition, approximately 50% of type 1 DM (T1DM) patients, especially those with
longstanding disease, have evidence of delayed gastric emptying.
Dietary modification is one of the treatment pillars for patients with dyspeptic symptoms.
Further, many individuals in which both symptoms and motility abnormalities improve after a
GFD have positive anti-gliadin antibodies (AGA), which reinforces the role of gluten-induced
inflammation/immune activation as a possible cause of motility abnormalities and related
symptoms.
Ameliorating UGI symptoms is not only pivotal for improving the quality of life of diabetic
GP patients, but the improvement in gastroduodenal motility is also needed for a more
predictable glycemic response. In non-celiac T1DM patients, the role of the GFD in symptom
improvement, gastroduodenal motility and glycemic control has never been assessed.
The overall aim of the present study is to improve the knowledge about the role of dietary
interventions as non-pharmacological treatments for upper-gastrointestinal symptoms and
underlying motility abnormalities in patients with type 1 diabetes. This will be a
non-randomized, open label, before and after trial of a 1-month GFD in non-celiac type 1
diabetics to assess symptomatic, motility and glycemic response changes.
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