Abstract
Gluten seems a potentially important determinant in type 1 diabetes (T1D) and type 2 diabetes (T2D). Intake of gluten, a major component of wheat, rye, and barley, affects the microbiota and increases the intestinal permeability. Moreover, studies have demonstrated that gluten peptides, after crossing the intestinal barrier, lead to a more inflammatory milieu. Gluten peptides enter the pancreas where they affect the morphology and might induce beta-cell stress by enhancing glucose- and palmitate-stimulated insulin secretion. Interestingly, animal studies and a human study have demonstrated that a gluten-free (GF) diet during pregnancy reduces the risk of T1D. Evidence regarding the role of a GF diet in T2D is less clear. Some studies have linked intake of a GF diet to reduced obesity and T2D and suggested a role in reducing leptin- and insulin-resistance and increasing beta-cell volume. The current knowledge indicates that gluten, among many environmental factors, may be an aetiopathogenic factors for development of T1D and T2D. However, human intervention trials are needed to confirm this and the proposed mechanisms.
Highlights
Gluten seems a potentially important determinant in type 1 diabetes (T1D) and type 2 diabetes (T2D)
As for T1D and celiac disease (CD), genetic susceptibility genes are important disease determinants in T2D, and so far studies have found over 40 associated genes, only a few of them have been verified in several patients and laboratories including peroxisome proliferator activated receptor gamma (PPARG), ATP
We showed that long-term feeding of B6 mice with a gluten-free high-fat (GF-HF) versus a HF diet increased the beta-cell volume and improved the glucose tolerance [150], which we believe could be a result of beta-cell rest, as we have shown that gluten potentiates the fatty acid-stimulated insulin secretion [108]
Summary
There has been a tremendous increase in the number of GF products available with the promise of diverse health benefits. The incidence of celiac disease (CD) was estimated to be 33.6 per 10,000 person-years in a recent retrospective cohort study from the United. Gluten is classified as a prolamin, containing monomeric gliadins and polymeric glutenins. Α-gliadin contains some of the most toxic peptides in gluten, as evidenced by in vitro studies, and their effect has been mapped to specific domains in the structure [12]. The 33-mer is resistant to degradation by intestinal peptidases [18,19] and was recently identified in all of the modern and old cultivars of wheat and spelt analysed [20]
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