Elimination of dietary gluten does not reduce titers of type 1 diabetes-associated autoantibodies in high-risk subjects

Diabetes Care. 2002 Jul;25(7):1111-6. doi: 10.2337/diacare.25.7.1111.


Objective: Removal of the dietary wheat protein gluten protects against autoimmune diabetes in animal models. Furthermore, elimination of dietary gluten reduces the frequency of type 1 diabetes in patients with celiac disease. Herein we test the hypothesis that gluten is the driving antigen for type 1 diabetes-associated islet autoimmunity.

Research design and methods: Seven autoantibody-positive, first-degree relatives of patients with type 1 diabetes were placed on a gluten-free diet for 12 months followed by gluten reexposure for 12 months. Gliadin antibodies as well as the diabetes-related antibodies insulin autoantibody (IAA), GAD antibody (GADA), and tyrosin phosphatase IA2 antibody (IA-2A) were measured every 3 months; oral glucose tolerance tests were performed every 6 months. Changes in autoantibody titers were compared with those observed in a matched historical cohort.

Results: A reduction in IgG gliadin antibody titers was observed during the gluten-free period, but titers of diabetes-associated autoantibodies changed independently of gluten exposure. Type 1 diabetes-associated islet autoantibody levels at the end of the gluten-free diet period were not significantly different from those before commencement of the diet (P = 0.2) or at the end of the gluten reexposure period (P = 0.4). Changes in individual subjects were identified, but no differences were noted between the gluten-free and the gluten re-exposure periods, and the changes were similar to those observed in the historical control cohort (P = 1.0). Major titer reductions (>50%) in the gluten-free period were observed in only one subject for all antibodies. Type 1 diabetes developed in this subject and in a second subject during the gluten reexposure period.

Conclusions: The findings do not support the hypothesis that gluten is a driving antigen in type 1 diabetes.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autoantibodies / blood*
  • Autoantibodies / immunology
  • Child
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 1 / immunology*
  • Diet, Diabetic*
  • Disease Progression
  • Family
  • Female
  • Glutamate Decarboxylase / immunology
  • Glutens*
  • Humans
  • Islets of Langerhans / immunology
  • Male
  • Models, Animal
  • Patient Compliance
  • Patient Selection
  • Risk Factors


  • Autoantibodies
  • islet cell antibody
  • Glutens
  • Glutamate Decarboxylase