Celiac.com 11/06/2007 - This study investigated the effect of screening detected celiac disease in type I diabetic children in a multi-center case-control fashion. The research team consisted of B Rami, Z Sumni, E Schober et al from Austria, Czech Republic, and Slovenia, among other European countries.
Although a clear link between type I diabetes and increased risk of celiac disease is established, the benefit of a gluten-free diet is unclear in these children. This study followed 98 patients with diabetes and silent celiac for a mean of 3.3 years and compared them to 196 controls. This is the largest, best designed case-control study to date and it did not demonstrate any significant differences between the two groups, except for a decreased Body Mass Index (BMI - though still greater than non-diabetic, control children) in males after diagnosis.
What is more intriguing is that at diagnosis, no significant differences in height, BMI, HbA1c, insulin need, or hypoglycemia events were seen, questioning the metabolic significance of silent celiac disease. In this study, it is difficult to estimate the duration of silent celiac disease prior to diagnosis. Although, given the fact that these patients were asymptomatic and their mean diabetes duration was 3.6 years, it likely implies that silent celiac disease was present for a few years.
The data regarding the benefit of a gluten-free diet in screening detected celiac disease in type I diabetic children is scant but is slowly increasing. Numerous psychological (burden of gluten free diet in addition to diabetic diet), cost (of diet), and ethical issues (potential long-term benefits of gluten-free diet, compliance with diet) exist regarding these children and hopefully this question will be answered soon and with good, convincing data.
Journal of Pediatric Gastroenterology and Nutrition, 41:317-321, 2005