If someone in your family has type 1 diabetes, you should be screened for celiac disease, a chronic condition in which the wall of the small intestine is damaged by a toxic reaction to gluten, a substance found in some grains. Untreated celiac disease can lead to a number of nutritional deficiencies, according to the Celiac Disease Foundation.

According to the August 2000 issue of Diabetologia, an ongoing study in Germany that tested more than 900 children of parents with type 1 diabetes for diabetes-associated antibodies, has shown that a significant number of those offspring have celiac disease-associated autoimmunity and display the silent form of celiac disease early in life.

The chances of testing positive for celiac antibodies increased as the children aged. The researchers note that incidents increased more sharply until the age of five, then fell off slightly. A little more than two in 100 two-year-olds tested positive, but that number more than doubled to five chances in 100 by the age of five. By the time the children reached the age of eight, their chances of showing the antibodies had increased only slightly more, to 6.5 chances in 100.

In a control group of 71 children less than eight years of age who did not have a parent with diabetes, only about 1 in 100 showed antibodies for celiac disease. Those newly diagnosed with diabetes were at an even higher risk of showing antibodies. Of 99 people with an average age of 11.4 years who were newly diagnosed with diabetes, about one in 10 showed antibodies for celiac disease.

Researchers also noted that one child who had showed autoimmunity associated with both diabetes and celiac disease lost the autoimmunity to islets after beginning a gluten-free diet. That response led researchers to note that, in some people, treating celiac disease could affect whether a person develops diabetes.

Because of the larger percentage of children who showed antibodies to celiac disease, researchers strongly urge testing for all first-degree relatives of people with type 1 diabetes.