Gut-Brain Disorders Common in Children with Celiac Disease Despite Gluten-Free Diet

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A groundbreaking study reveals that disorders of gut-brain interaction (DGBI) are surprisingly common among children with celiac disease (ced), even when they diligently adhere to a gluten-free diet. The research, conducted at Cincinnati Children’s Hospital medical Center (CCHMC), highlights the importance of considering DGBI in pediatric CeD patients who continue to experience gastrointestinal issues despite proper disease management.

Prevalence of DGBI in Pediatric Celiac patients

the retrospective chart review, encompassing nearly 200 pediatric CeD patients, found that a significant 43% met the Rome IV diagnostic criteria for DGBI Rome IV diagnostic criteria. Functional constipation (33%) and functional abdominal pain (29%) were the most prevalent DGBI diagnoses within this cohort.

Did You No? DGBI, formerly known as functional gastrointestinal disorders, affect approximately one-third of adults and 25% of children aged 4-18 years.

Key findings on Risk Factors

The study identified several factors that increase the likelihood of developing DGBI in children with celiac disease. Presenting symptoms such as abdominal pain (OR, 3.09), constipation (OR, 2.19), vomiting (OR, 2.36),and nighttime pain awakening (OR,9.76) at the initial visit were significant predictors. Moreover, patients with complete villous blunting, a marker of severe intestinal damage, also faced an elevated risk (OR, 2.28).

Additional analysis revealed that comorbid conditions, including joint hypermobility syndrome (OR, 5.23), headaches (OR, 3.47), chronic musculoskeletal pain (OR, 3.20), chronic muscle pain (OR, 5.61),and any comorbid

Semaglutide (Ozempic) Shows Promise in Improving Walking Distance for Type 2 Diabetes Patients with PAD

Chicago, IL – New findings from a subanalysis of the STRIDE trial, presented at the American Diabetes Association (ADA) 2025 conference, indicate that semaglutide 1.0 mg (Ozempic) provides significant benefits for individuals with type 2 diabetes and peripheral artery disease (PAD). The research demonstrates significant improvements in walking distance, regardless of HbA1c levels or other diabetes treatments [1].

Semaglutide’s Impact on Peripheral Artery Disease

The STRIDE trial, a double-blind, randomized, placebo-controlled study, investigated the effects of semaglutide on walking distance in patients with type 2 diabetes and PAD. The study, which began in 2020, involved 792 patients across 20 countries who were randomly assigned to receive either semaglutide or a placebo for 52 weeks [2].

Did You Know? Peripheral artery disease affects over 200 million people worldwide, and those with diabetes are at a higher risk.

The primary endpoint of the trial focused on the ratio from baseline in maximum walking distance at 52 weeks. Results showed a significant advantage for semaglutide, with an estimated treatment ratio (ETR) of 1.13 (95% CI, 1.06-1.21; *P* = .0004). Secondary outcomes further supported these findings, including greater betterment in walking distance, significantly higher quality-of-life scores, and improved pain-free walking distance [3].

Key Findings Presented at ADA 2025

professor Subodh Verma, MD, PhD, a cardiovascular surgeon at the University of Toronto and senior author of the STRIDE trial, presented a subanalysis at ADA 2025, highlighting that semaglutide was associated with significantly improved walking outcomes, enhanced quality of life, and a 54% reduction in the risk of disease progression.The median ratio to baseline in maximum walking distance was 1.21 in the semaglutide group compared to 1.08 in the placebo group at week 52 [4].

Pro Tip: Regular monitoring of foot health is crucial for individuals with diabetes and PAD to prevent complications.

Efficacy data indicated that the positive effects of semaglutide were independent of baseline glycemic control, duration of diabetes, or intensity of diabetes treatment.The effects were also consistent across different BMI categories and irrespective of background SGLT2 inhibitor use.

Safety and Tolerability

Additional safety data from the STRIDE trial demonstrated that semaglutide was well-tolerated, with no treatment-related deaths and a safety profile consistent with prior data.This reinforces semaglutide as a safe and effective treatment option for this patient population

Masked Tapering Boosts Benzodiazepine Discontinuation for Insomnia Patients: SLEEP 2025

SEATTLE, WA – A novel approach to benzodiazepine deprescribing, combining masked tapering with augmented cognitive behavioral therapy for insomnia (CBT-I), shows promising results in helping older adults discontinue long-term use of these medications. The findings, presented at SLEEP 2025, highlight the potential of this method to improve sleep quality and reduce reliance on benzodiazepines (BZRA) among individuals with insomnia.

The Masked Tapering Approach

researchers,led by Dr. Constance Fung from the David Geffen School of Medicine at UCLA,developed a Masked Taper plus cognitive behavioral therapy-augmented program (MTcap) to minimize placebo effects and boost discontinuation. The study involved 188 adults aged 55 and older (average age 69.2 years, 34.6% female) who had been using alprazolam, lorazepam, temazepam, or zolpidem for at least two nights per week for a minimum of three months. Participants used a BZRA an average of 5.9 days a week.

Did You Know? Benzodiazepines are associated with a 36% increased risk of dementia in older adults, according to a 2012 study in JAMA Internal medicine.

Study Results: MTcap vs. Standard Tapering

The multi-site trial compared eight weeks of MTcap with standard, gradual tapering. Six months after treatment, the MTcap group showed a significantly higher BZRA discontinuation rate (73.4%) compared to the standard tapering group (58.6%). Both groups experienced improvements in insomnia severity, as measured by the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index.

Specifically, baseline epworth Sleepiness Scale scores increased from 6.32 and 6.21 at baseline for MTcap and standard taper,respectively,to 3.98 and 3.92 at 1 week and 4.54 and 3.91at 6 months. Pittsburgh Sleep Quality index scores also showed improvements from baseline to week 1 and month 6 in both arms.

Challenging Thoughts About Medication

A key element of the masked tapering program involved a diary where participants recorded their perceived nightly dosage compared to their baseline dose. This approach encouraged patients to question the actual effectiveness of their medication.

Pro Tip: Gradual tapering, combined with behavioral therapies, is recommended by the American Academy of Family Physicians for safe benzodiazepine discontinuation.

Dr. Fung emphasized the importance of patients asking themselves, “Is this pill really doing something for me?” The goal is for patients to recognize that they may not be sleeping well and may not necessarily need a sleeping pill after completing the MTcap program.

Future Research Directions

Further analyses are planned to gain a better understanding of the factors contributing to the sustained discontinuation rates observed in the study. researchers aim to identify the specific mechanisms through which masked tapering and augmented CBT-I promote long-term success.

What strategies have you found most effective in managing insomnia without medication? How can healthcare providers better support patients in safely discontinuing benzodiazepines?

Disclaimer: This article provides general information and should not be considered medical advice. Consult with a healthcare professional for personalized guidance on benzodiazepine discontinuation and insomnia treatment.

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