A34 GLUTEN-FREE DIET IMPROVES DYSPEPTIC SYMPTOMS IN PATIENTS WITH TYPE 1 DIABETES IN WHOM CELIAC DISEASE WAS EXCLUDED
Notice bibliographique
Résumé
Abstract Background Patients with type 1 Diabetes Mellitus (T1DM) often suffer from dyspeptic symptoms, such as abdominal pain, bloating, early satiety, nausea and vomiting. T1DM shares genetic risk factors (HLA-DQ2 and DQ8) with celiac disease, an autoimmune disorder caused by an immune reaction to gluten. Patients with concomitant T1DM and celiac disease benefit from a gluten-free diet (GFD), as it improves their symptoms, gastric emptying and small intestinal inflammation. However, it is unknown whether GFD has any benefit in patients with T1DM without celiac disease, who present with symptoms of dyspepsia or gastroparesis. Aims To investigate the role of a GFD in the management of moderate to severe dyspeptic symptoms in non-celiac patients with T1DM. Methods We enrolled 13 adult T1DM patients, in whom celiac disease was ruled out, suffering from two or more upper GI symptoms. The patients were instructed to adhere to a strict GFD for a period of 1 month, under the supervision of a dietitian. Glycemic levels were monitored by a continuous glucose monitoring device (CGM) for 2 weeks before, and at the end of the GFD period. Standardized questionnaires were used to assess upper GI symptoms (Gastroparesis Cardinal Symptoms Index, Short Form Leeds Dyspepsia questionnaire), general quality of life (Patient Assessment of Upper GI Disorders Quality of Life), and anxiety and depression (Hospital Anxiety Depression scale). Blood samples were collected to assess glycaemia (Hb1Ac) and immune markers. Scintigraphy and videofluoroscopy were used to assess gastric emptying. Results After one month on a GFD, T1DM patients reported a significant improvement in nausea (p<0.05), sensation of fullness (p<0.001) and bloating (p<0.0001). Overall dyspepsia symptoms also improved (p<0.01), with 92% of patients reporting decreased dyspepsia scores. Moreover, there was an improvement in the quality of life (p<0.01), and decreased scores of anxiety and depression (p<0.01 and p<0.05, respectively). There were no changes in gastric emptying or glycemic management metrics, such as mean glucose level, time in target, glucose variance or HbA1c levels. Interestingly, one year after the end of the study, 63.6% of participants continued to follow a GFD. The most common reason to remain on a GFD reported by these patients was “because it improved GI symptoms”. Questionnaire data collected at the follow-up demonstrated that the improvement of dyspeptic symptoms persisted after 1 year on GFD (p<0.001). Conclusions GFD improves dyspeptic symptoms in T1D patients without concomitant celiac disease, without affecting their glycemic levels or gastric emptying. Although these results need to be validated in a larger study, our data suggest that GFD could be used as a therapeutical tool for T1DM patients grappling with burdensome upper GI symptoms. Gluten-Free diet improves dyspepsia symptoms in Type 1 Diabetes patients, after 1 month and 1 year Funding Agencies CIHR
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».