Altered intestinal permeability to mannitol in diabetes mellitus type I

Background: Intestinal permeability has seldom been investigated in diabete s mellitus, even though patients frequently report gastrointestinal symptom s, and it has recently been shown that the prevalence of celiac disease ass ociated with diabetes mellitus is higher than expected. Methods: Intestinal permeability to cellobiose and mannitol was investigate d in 31 patients affected by type I uncomplicated diabetes mellitus. Values were compared with those obtained in 32 normal subjects. Results: The percentage of mannitol recovery was far higher than normal in two thirds of the investigated patients and correlated with the length of d isease, even though the probes' ratio (cellobiose/mannitol) was in the norm al range. Conclusions: A not previously reported increase of intestinal permeability to mannitol, clear-cut and not associated with that of the larger probe, is found in type I uncomplicated diabetes mellitus. These results may describ e a primary feature of type I diabetes mellitus and the initial steps of ev olution to celiac disease.