The Effect of Gluten-free Diet in Type 1 Diabetics With Dyspepsia Symptoms
The Effect of Gluten-free Diet on Upper Gastrointestinal Symptoms in Type 1 Diabetic Patients With Dyspepsia-like Symptoms
Lead Sponsor: McMaster University
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.
|Overall Status||Unknown status|
|Start Date||December 15, 2017|
|Completion Date||June 30, 2018|
|Primary Completion Date||June 1, 2018|
Intervention Type: Other
Intervention Name: Gluten-free diet
Description: One-month gluten-free diet
Arm Group Label: Gluten-free diet
Inclusion Criteria: - Adult men and women (18-75 years) with type 1 diabetes diagnosis and no history of celiac disease, that complain of upper gastrointestinal symptoms (early satiety, postprandial fullness, bloating, abdominal swelling, nausea, vomiting, and retching) will be invited to participate. Exclusion Criteria: - Patients with very severe symptoms of gastroparesis that require specialized nutritional therapy or surgical treatment; - Pregnant women; - Patients with concomitant diseases/treatments that can alter gastrointestinal motility and concomitant severe systemic diseases.
- Adult men and women (18-75 years) with type 1 diabetes diagnosis and no history of celiac disease, that complain of upper gastrointestinal symptoms (early satiety, postprandial fullness, bloating, abdominal swelling, nausea, vomiting, and retching) will be invited to participate.
- Patients with very severe symptoms of gastroparesis that require specialized nutritional therapy or surgical treatment;
- Pregnant women;
- Patients with concomitant diseases/treatments that can alter gastrointestinal motility and concomitant severe systemic diseases.
Minimum Age: 18 Years
Maximum Age: 75 Years
Healthy Volunteers: No
Last Name: Premysl Bercik, MD, PhD
Phone: 1 905 521 2100
Phone Ext.: 73495
Email: [email protected]
|Has Expanded Access||No|
|Number Of Arms||1|
Label: Gluten-free diet
Description: All patients will follow a strict gluten-free diet for 1 month. Measurement will be conducted at baseline and after the intervention.
|Study Design Info||
Intervention Model: Single Group Assignment
Intervention Model Description: Before and after clinical trial.
Primary Purpose: Treatment
Masking: None (Open Label)