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Long-term Celiac Disease Increases Death Rates in People with Type 1 Diabetes

Celiac.com 06/26/2013 - Do people with type 1 diabetes (T1D) and celiac disease die younger than people with T1D who do not have celiac disease? Do celiac patients without T1D live longer than those with T1D? Currently, not much is known about how celiac disease might influence mortality rates in people with T1D.

Photo: CC--SkenderA team of researchers recently set out to examine rates of death in patients with both T1D and celiac disease. The researchers include K. Mollazadegan, D.S. Sanders, J. Ludvigsson, and J.F. Ludvigsson. The are variously affiliated with the Clinical Epidemiology Unit of the Department of Medicine, Solna, Karolinska Institutet, and with St. Erik Eye Hospital, Karolinska Institutet in Stockholm, Sweden.

The research team set out to examine mortality in patients with both type 1 diabetes (T1D) and celiac disease. For their study, the team used biopsy reports to identify all people diagnosed with celiac disease between 1969 and 2008, within all 28 pathology departments in Sweden. They defined T1D as a diagnosis of diabetes recorded in the Swedish National Patient Register between 1964 and 2009 in individuals aged ≤30 years.

Their follow-up showed 960 patients with both T1D and celiac disease. For each individual with T1D and celiac disease, they selected up to five subjects with T1D alone (no celiac disease) as a reference group of 4608 individuals. They then matched all reference individuals for sex, age and calendar period of diagnosis.

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The team used stratified Cox regression analysis with celiac disease as a time-dependent covariate to estimate the risk of death in patients with both T1D and celiac disease compared to those with T1D alone.

The results showed that celiac disease was not a risk factor for death in patients with T1D in the first 5 years after celiac disease diagnosis [hazard ratio (hazard ratio) 0.87, 95% confidence interval (CI) 0.43-1.73].

However, with the passage of time, that reality changed, and mortality risk rose in direct relation to follow-up time (5 to

In the end, for people with T1D, having a celiac disease diagnosis for at least 15 years was associated with a 2.80 times greater risk of death (95% CI 1.28-6.12).

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