Beta-Cell Autoimmunity Screens Unwarranted in Celiac Children

Celiac.com 03/09/2009 - Due to seemingly low rates of beta-cell autoimmunity among children with celiac disease, there is no need to screen these children for beta-cell autoimmunity markers, according to a report by Italian doctors in the February issue of Diabetes Care.

Dr. Giuseppe D'Annunzio, of the University of Genoa, and colleagues recently set out to determine which pediatric celiac patients might warrant beta-cell autoimmunity screening. His research team assessed 188 children who received celiac disease diagnosis at an average age of 5.8 years, and who had had the disease for 4.2 years on average.

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The doctors confirmed gluten-free diet compliance by testing for anti-endomysial antibodies and endomysial tissue transglutaminase antibodies.

Nine of the children (4.8%) tested positive for diabetes-related auto-antibodies. However, all of these children showed normal fasting blood glucose and A1C levels and, after 36 months of follow-up, none developed type 1-diabetes.

The researchers note that there is, between celiac disease and juvenile diabetes, a shared prodromic stage, with “auto-antibodies to islet or gut antigens.” Still, they note that their findings support those of other investigators, and that routine screening for diabetes-related antibodies in children with celiac disease is not warranted.

Diabetes Care 2009; 32:254-256.