Celiac.com 10/13/2016 - Researchers don't currently know much about rates of celiac disease autoimmunity or tissue transglutaminase autoantibodies (TGA) in patients with type 1 diabetes (T1D) and autoimmune thyroid disease (AITD) in the Chinese population.

A team of researchers recently set out to assess rate of celiac disease autoimmunity amongst patients with T1D and AITD in the Chinese population. The research team included Zhiyuan Zhao, Jing Zou, Lingling Zhao, Yan Cheng, Hanqing Cai, Mo Li, Edwin Liu, Liping Yu, and Yu Liu.

The study included 178 patients with type 1 diabetes, along with 119 with AITD where 36 had both T1D and AITD, classified as autoimmune polyglandular syndrome type 3 variant (APS3v). The study also included 145 patients with type 2 diabetes (T2D), 97 patients with non-autoimmune thyroid disease (NAITD), and 102 healthy control subjects.

The team used radioimmunoassay to measure serum islet autoantibodies, thyroid autoantibodies and TGA. They found TGA positivity in 22% of patients with either type 1 diabetes or AITD, much higher than the 3.4% seen in T2D patients (p< 0.0001) the 3.1% seen in NAITD patients (P < 0.0001) or the 1% seen in healthy controls (1%; p<0.0001).

Thirty-six percent of patients with APS3v who had both T1D and AITD positive for TGA, significantly higher than patients with T1D alone (p = 0.040) or with AITD alone (p = 0.017). At diagnosis, T1D and AITD showed overlap frequencies of 20% and 30%, respectively.

Chinese population with existing T1D and/or AITD shows high rates of TGA positivity, which are even higher in people with both diseases.

The study team recommends routine TGA screening in patients with T1D or AITD will help to identify celiac disease autoimmunity early on, and will yield better clinical patient care.

Source:

• Open Original Shared Link

A team of researchers recently set out to examine the effects of a gluten-free diet lipid on profiles of patients with Type 1 diabetes. They study was conducted on behalf of the for the Diabetes Study Group of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED). The research team included Silvana Salardi, Giulio Maltoni, Stefano Zucchini, Dario Iafusco, Santino Confetto, Angela Zanfardino, Sonia Toni, Barbara Piccini, Maximiliano Zioutas, Marco Marigliano, Vittoria Cauvin, Roberto Franceschi, Ivana Rabbone, Barbara Predieri, Riccardo Schiaffini, Alessandro Salvatoni, Petra Reinstadler, Giulia Berioli,Valentino Cherubini and Giuseppe d'Annunzio.

They are variously affiliated with the Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy, the Department of Pediatrics, Second University of Naples, Naples, Italy, the Meyer Children's Hospital, University of Florence, Florence, Italy, the Regional Center for Pediatric Diabetes, Clinical Nutrition & Obesity, Department of Life & Reproduction Sciences, University of Verona, Verona, Italy, the Pediatric Unit, S. Chiara Hospital, Trento, Italy, the Department of Pediatrics, University of Turin, Turin, Italy, the Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy, the Endocrinology and Diabetes Palidoro Unit at the University Department of Pediatric Medicine, Bambino Gesu Children's Hospital, IRCCS, Rome, Italy, the Pediatric Clinic, Insubria University, Varese, Italy, the Department of Pediatrics, Regional Hospital, Bolzano, Italy, the Department of Gynaecological, Obstetric and Paediatric Sciences at the University of Perugia in Perugia, Italy, the Division of Paediatric Diabetes in Children and Adolescents, Maternal-Infantile Department, Salesi Hospital, Ancona, Italy, and with the Department of Pediatrics, IRCCS Gaslini Children's Hospital at the University of Genova in Genova, Italy.

From 13 centers within the Italian Society of Pediatric Endocrinology and Diabetology (ISPED), the team collected data on a large number of children with both T1D and concurrent biopsy-proven celiac disease. They collected data at the time they initiated a gluten-free diet, and again after 1 year of a gluten-free diet. They verified gluten-free status using serum tests for celiac disease-related antibodies.

They enrolled 201 children with T1D diagnosed at age of 5.8 +/- 3.8 years, and celiac disease diagnosed at age of 7.5 +/- 4.5 years. To compensate for any metabolic derangement at diabetes onset, they included only cases in which celiac disease diagnosis was made at least 3 months after that of T1D.

As a control group, they used 224 patients with T1D only, matched by age, sex, diabetes duration, and HbA1c.

Before subjects began a gluten-free diet, the team found that HDL-C values were significantly lower in children with celiac disease and T1D than in the control group, with the greatest decrease found in younger children aged, 6 years. Subjects with HDL-C values below pediatric percentile cutoffs for sex and age were younger than those with normal values (6.2 +/- 4.4 vs. 8.6 +/- 4.3 years, P , 0.0001) and also had lower HbA1c (7.5 +/- 0.8 vs. 8.0 +/- 1.5%, P , 0.005).

After a gluten-free diet the average values of HDL-C in the total study population rose sharply to 60.9 +/- 13.7, compared with 51.3 +/- 13.6 mg/dL (P , 0.0001), and returned to normal.

The percentage of subjects with HDL-C values lower than pediatric percentile cut points fell significantly (P , 0.0001) from 42 to 16%. Subjects with complete adherence to gluten-free diet showed the most significant improvement of HDL-C, and subjects with partial adherence showed a lower, but significant, improvement of HDL-C.

These results dovetail with other data from the past few years, but more clearly indicated the reduction in HDL-C at diagnosis, and the better recovery with a gluten-free diet. The researchers view the reduction HDL-C either as a proxy marker for intestinal inflammation, or as the result of a change in the intestinal secretion of apolipoprotein AI (5), the major HDL structural protein.

This change is seen most sharply in the youngest children, who probably suffer more severely, as indicated by signs of malabsorption, e.g., lower HDL-C and HbA1c levels. Children with T1D and untreated celiac disease, especially young children, typically show an unfavorable lipid profile, i.e., low HDL-C values.

Following a gluten-free diet normalizes HDL-C levels, with the greatest benefits can be seen in individuals who follow the diet strictly, and in the youngest individuals.

Because of the possibility of increased risk of cardiovascular disease, a strict gluten-free diet is mandatory in these children.

Source:

• Open Original Shared Link

The study found that a maternal gluten-free diet reduces inflammation and diabetes rates in the offspring of non-obese diabetic mice.

The study was conducted by a research team that included Camilla H.F. Hansen, Åukasz Krych, Karsten Buschard, Stine B. Metzdorff, Christine Nellemann, Lars H. Hansen, Dennis S. Nielsen, Hanne Frøkiær, Søren Skov, and Axel K. Hansen. They are variously affiliated with the Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark, the Department of Food Science, Faculty of Science, University of Copenhagen, Frederiksberg, the Bartholin Institute, Rigshospitalet, Copenhagen, Denmark, the Division of Toxicology and Risk Assessment, National Food Institute, Technical University of Denmark, Søborg, Denmark, and the Department of Biology, Faculty of Science, University of Copenhagen in Copenhagen, Denmark.

Researchers have known for some time that early life interventions in the intestinal conditions have been shown to influence diabetes rates in mice. For example, a gluten-free diet in known to decrease type 1 diabetes incidence. Their team hypothesized that a gluten-free diet for pregnant mice only during pregnancy and lactation period would protect offspring mice against development of diabetes.

The team fed pregnant non-obese diabetic (NOD) mice either a gluten-free or a standard diet, until all mice pups were weaned to standard diet. The early gluten-free mice showed significantly lower rates of diabetes and insulitis. Gut microbiota analysis by 16S rRNA gene sequencing showed significantly increased Akkermansia, Proteobacteria, and TM7 between both mothers and their offspring in the gluten-free diet group.

Moreover, the gluten-free offspring showed increased pancreatic FoxP3 regulatory T cells, along with an increase in M2 macrophage gene markers and tight junction-related genes in the gut, coupled with lower intestinal gene expression of pro-inflammatory cytokines. Higher numbers of T cells in the pancreas expressing the mucosal integrin α4β7 suggests that the mechanism involve increased trafficking of gut-primed immune cells to the pancreas.

This study supports the conclusion that a gluten-free diet during fetal and early postnatal life reduces development of diabetes. This may be due to changes in gut microbiota and better inflammatory and immunological conditions in the gut and pancreas.

So, could it be that human mothers who eat a gluten-free diet through weening can impart the same kind of protection against diabetes? Clearly more studies need to be done until we can know for sure, but following a gluten-free diet while pregnant probably wouldn’t cause any harm to the mother or the baby.

Source:

• Open Original Shared Link

A team of researchers recently set out to assess the role of gluten in celiac disease and Type 1 diabetes. The research team included G Serena, S Camhi, C Sturgeon, S Yan S, and A Fasano. They are variously affiliated with the Graduate Program in Life Sciences at the University of Maryland School of Medicine in Baltimore, Maryland and with the Center for Celiac Research, Mucosal Immunology and Biology Research Center at Massachusetts General Hospital and Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children in Boston.

Some studies have shown dietary gluten has been proven to play a role in both celiac disease and type 1 diabetes (T1D), and others have suggested a the same.

In celiac disease, gluten is the know autoimmune trigger. When the trigger is removed by the patient following a gluten-free diet, that autoimmune process stops, the gut heals, and the patient's serological markers for celiac disease usually return to normal.

However, for T1D, researchers have not been able to find a causative agent, something like gluten in celiac disease. Nevertheless, researchers continue to debate the role of dietary gluten in development of T1D, and the potentially beneficial effect of removing gluten from the diet of patients with T1D.

In a recent review, their team discusses the comorbid occurrence of celiac disease and T1D and explore current evidences for the specific role of gluten in both conditions, specifically focusing on current evidence on the effect of gluten on the immune system and the gut microbiota.

Read more in Open Original Shared Link.

Meanwhile, reports about the impact of celiac autoimmunity in T1DM have been varied. A team of researchers recently set out to determine rates of celiac autoimmunity in patients with T1DM, and to study the impact of celiac autoimmunity on nutritional parameters, glycaemic control, endocrine axes and bone health.

The research team included A.S. Joshi, P.K. Varthakavi, N.M. Bhagwat, M.D. Chadha, AND S.S. Mittal. They are variously associated with the Department of Endocrinology of Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai Central in Maharashtra, India.

For their study, the team conducted celiac autoimmunity screens on eighty-six consecutive patients with T1DM using immunoglobulin A (IgA) tissue transglutaminase as a marker (TTG; IgG anti-gliadin in IgA-deficient case). They compared CA positive (CA+) T1DM cases with age-matched and sex-matched CA negative (CA-) T1DM cases for anthropometry, glycaemic control (as assessed by glycated haemoglobin (HbA1c) and hypoglycaemic/hyperglycaemic episodes), endocrine (thyroid function, cortisol, growth hormone (GH) axis, gonadal axes), haematological (haemoglobin, iron profile and vitamin B12 status) and calcium metabolism parameters and bone densitometry (by dual-energy X-ray absorptiometry (DXA)).

Consenting patients with celiac autoimmunity also underwent upper gastrointestinal (GI) endoscopy with duodenal biopsy.

Results showed that 11 of the 86 patients, about 12.75%, screened positive for celiac autoimmunity. Of those, seven patients underwent duodenal biopsies which suggested two cases of Marsh grade III, three cases of Marsh grade II and two cases of Marsh grade I celiac disease.

In terms of anthropometry, CA+ T1DM patients were comparable with CA- T1DM patients. Overall, CA+ patients had higher HbA1c (10.7±1.8 vs. 8.4±1.0 (93±19 vs. 68±11 mmol/mol); p

The incidence of fractures in the past 3 years was four CA+ patients, and one CA- patient (p<0.05).

There is an important autoimmune connection between celiac disease and T1DM. For people with T1DM, celiac disease adversely affects stature, bone health, glycaemic control and iron and B12 levels.

The study team recommends that IgA sufficiency be established before using an IgA-based screening test for celiac autoimmunity.

Source:

• Open Original Shared Link

Celiac.com 07/14/2014 - Early life intestinal problems have previously been shown to influence diabetes rates. There is also some evidence that a gluten-free diet can lower rates of diabetes, but just how strong is the influence of gluten-free diet on the development of diabetes?

A recent study by a group of researchers in Denmark suggests that maternal gluten-free diet greatly reduces inflammation and rates of diabetes in the offspring of certain mice. This study led the team to hypothesize that a gluten-free diet, which is known to decrease type 1 diabetes incidence, may also offer protection against diabetes when followed during the pregnancy and lactation period.

The research team included Camilla H.F. Hansen, Åukasz Krych, Karsten Buschard, Stine B. Metzdorff, Christine Nellemann, Lars H. Hansen, Dennis S. Nielsen, Hanne Frøkiær, Søren Skov and Axel K. Hansen. They are variously affiliated with the Department of Veterinary Disease Biology of the Faculty of Health and Medical Sciences at the University of Copenhagen, the Department of Food Science, Faculty of Science, University of Copenhagen, the Department of Biology, Faculty of Science, University of Copenhagen, the Division of Toxicology and Risk Assessment of the National Food Institute at the Technical University of Denmark in Søborg, Denmark, and the Bartholin Institute in Copenhagen, Denmark.

For their study, the team fed pregnant non-obese diabetic (NOD) mice either a gluten-free diet, or a standard diet, until all pups were weaned to standard diet. Overall, mice which experienced early life gluten-free diets had dramatically lower rates of diabetes and insulitis.

An analysis of gut microbiota using 16S rRNA gene sequencing showed a major difference between both mothers and their offspring, marked by higher levels of Akkermansia, Proteobacteria, and TM7 in the gluten-free diet group. Gluten-free fed offspring showed increased M2 macrophage gene markers and tight junction-related genes in the gut, along with higher levels of pancreatic FoxP3 regulatory T cells.

Gluten-free offspring also had reduced intestinal gene expression of proinflammatory cytokines. Finding more T cells in the pancreas expressing the mucosal integrin α4β7 suggests that this is due to an increase in gut-primed immune cells moving to the pancreas.

The study shows clearly that a gluten-free diet during the fetal and early postnatal life lowers rates of diabetes. This may be due to a change in gut microbiota and a reduction in pro-inflammatory conditions in the gut and pancreas.

Clearly, further study is needed to better understand the factors at play, and how they relate to diabetes reduction efforts.

Source:

• Open Original Shared Link

Celiac.com 07/11/2013 - A team of researchers wanted to better understand screening practices for celiac disease in patients with type 1 diabetes across North America. One question they sought to answer was whether diabetes centers screen for celiac disease in type 1 diabetes more frequently than other facilities.

The research team included S.M. Simpson, E.J. Ciaccio, S. Case, N. Jaffe, S. Mahadov, B. Lebwohl, P.H. Green. All except Case are affiliated with the Celiac Disease Center at Columbia University, New York, USA. Shelley Case runs her own nutrition consulting business in Regina, Saskatchewan.

For their study, the team conducted a survey with 27 questions on screening practices for celiac disease in patients with type 1 diabetes. The questions were compiled by experts in celiac disease and diabetes.

The team sent surveys by email to diabetes educators and dietitians throughout the United States and Canada between December 2010 and May 2011.

They received 514 responses from 484 endocrine clinics, diabetes clinics, private practices, community nutrition centers, and inpatient centers.

Thirty-five percent of these locations screened for celiac disease, with endocrine clinics reporting screening at the highest rate of eighty percent.

Not surprisingly, the most common test celiac disease test was tissue transglutaminase, while the most frequently recommended treatment of confirmed celiac disease was a gluten-free diet. However, only 365 respondents (71%) recommended biopsy in patients with positive blood results.

More than half of those responding (55.3%) reported that patient symptoms improved once they adopted a gluten-free diet.

Staff at endocrine clinics were most likely to suggest celiac disease testing for patients with type 1 diabetes.

Due to low screening frequency as well as inconsistency in management of positive celiac disease blood tests, the research team is calling for increased education regarding celiac disease in patients with type 1 diabetes, along with the adoption of uniform protocols.

Source:

• Open Original Shared Link

A 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.

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).

Source:

• Open Original Shared Link

The research team included Toufic A. Kabbani, Ciaran P. Kelly, Rebecca A. Betensky, Joshua Hansen, Kumar Pallav, Javier A. Villafuerte–Gálvez, Rohini Vanga, Rupa Mukherjee, Aileen Novero, Melinda Dennis, and Daniel A. Leffler.

They are variously affiliated with the Celiac Center, Department of Medicine, Division of Gastroenterology at Beth Israel Deaconess Medical Center, and the Harvard School of Public Health in Boston, Massachusetts.

For their study, the team assessed medical records of 840 patients with biopsy-proven celiac disease for diagnoses of NIDDM, hypertension, or hyperlipidemia; body mass index (BMI); lipid profile; and levels of glucose or glycosylated hemoglobin, to identify those with metabolic syndrome.

They matched 840 healthy control subjects for age, sex, and ethnicity. They then compared rates of NIDDM and metabolic syndrome in the celiac disease cohort with that of the controls and subjects included in the National Health and Nutrition Examination Survey.

The team found that 26 patients with celiac disease (3.1%) had NIDDM compared with 81 controls (9.6%) (P less than .0001).

Similarly, patients with celiac disease had lower rates of metabolic syndrome compared with the control group (3.5% vs 12.7%; P less than .0001).

The average BMI of patients with celiac disease was substantially lower than the BMI of control subjects (24.7 vs 27.5; P less than .0001).

However, even after controlling for BMI, celiac disease patients still had a lower risk of developing NIDDM, compared with non-celiac patients.

From this study, the team concludes that rates of NIDDM and metabolic syndrome are lower among patients with celiac disease than in matched controls and the general population.

These differences are not explained by differences in BMI. Further study is important so that researchers can determine exactly how celiac disease affects the risk for NIDDM and metabolic syndrome.

Source:

• Open Original Shared Link

Celiac.com 12/25/2012 - The connection between celiac disease and type 1 diabetes mellitus is well known. Up to now, very little has been reported about rates of celiac disease in children and adults with type 1 diabetes in Sicily.

A team of researchers recently set out to assess the prevalence of celiac disease in patients with type 1 diabetes mellitus who come from a specific region of western Sicily and to assess the clinical features of these patients.

The research team included D. Greco, M. Pisciotta, F. Gambina, and F. Maggio of the Division of Diabetology at Paolo Borsellino Hospital in Marsala, Italy.

For their study, they analyzed data from 492 consecutive patients with type 1 diabetes mellitus who were referred over a five year period.

They found that, of the 492 patients with type 1 diabetes, 14 females and eight males (a total of 4.5%) suffered from celiac disease. The patients averaged thirteen years of age at the time of diabetes onset.

The team found that patients were diagnoses with celiac disease either at about the same time as diabetes, or afterward. They found that eight patients (36%) had coexisting autoimmune thyroiditis.

Their data show that, within this Sicilian population, the association between celiac disease and type 1 diabetes is common, though at lower rates than in other studies of the Italian population. They also found high rates of autoimmune thyroiditis in these patients.

They also noted that celiac disease diagnosis often followed onset of type 1 diabetes, especially in females whose diabetes began at an early age. They conclude that this finding warrants an active search for the celiac disease for many years after the onset of diabetes.

Source:

• Open Original Shared Link

Celiac.com 10/10/2012 - Celiac disease is associated with type 1 diabetes (T1D), but little is known about the connection between celiac disease and diabetic retinopathy (DRP) in patients with T1D.

A research team recently set out to determine whether celiac disease is associated with a higher risk of diabetic retinopathy (DRP) in patients with T1D.

The researchers included Kaziwe Mollazadegan, MD; Maria Kugelberg, MD, PHD; Scott M. Montgomery, PHD; David S. Sanders, MB, CHB, FRCP, MD, FACG; Johnny Ludvigsson; MD, PHD; and Jonas F. Ludvigsson, MD, PHD.

They are affiliated with the Pediatric Clinic, and the Department of Clinical and Experimental Medicine in the Division of Pediatrics at Linköping University in Linköping, Sweden, with St. Erik Eye Hospital, and the Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; the Department of Pediatrics, and the Clinical Research Centre at Örebro University Hospital in Örebro, Sweden, Gastroenterology and Liver Unit, Royal Hallamshire Hospital and University of Sheffield, Sheffield, U.K.

Their study shows that longstanding celiac disease is associated with an increased risk of diabetic retinopathy in patients with type 1 diabetes.

The team conducted a population-based cohort study, in which they used the Swedish National Patient Register to identify 41,566 patients diagnosed with diabetes from 1964 to 2009, and who were 30 years of age or younger at the time of diagnosis.

The team defined celiac disease as the presence of villous atrophy (Marsh stage 3) according to small intestinal biopsies performed between 1969 and 2008, with biopsy reports obtained from Sweden’s 28 pathology departments.

During follow-up, the team found 947 T1D patients with celiac disease. They used Cox regression analysis with celiac disease as a time-dependent covariate to estimate adjusted hazard ratios (aHRs) for DRP in patients with T1D and celiac disease, and to compare them with patients with T1D but no celiac disease.

The results showed that the longer the patients had celiac disease, the higher their risk of DRP.

Once the team adjusted the results by time from celiac disease diagnosis, people with T1D and celiac disease showed a lower risk of DRP in the first 5 years after celiac disease diagnosis (aHR 0.57 [95% CI 0.36–0.91]), followed by a neutral risk in years 5 to
Between 10 and 15 years after diagnosis, patients with coexisting celiac disease showed a risk of 2.83 for DRP [95% CI 1.95–4.11. More than 15 years after follow-up, that higher risk rate went up to 3.01 [1.43–6.32]).

So, having celiac disease for more than 10 years is a risk factor for the development of DRP in patients with T1D. Therefore, the researchers note, physicians should conduct intense DRP monitoring in patients with long-standing celiac disease and T1D.

Source:

• Open Original Shared Link

Celiac.com 09/19/2012 - Researchers have documented rising rates of celiac disease in patients with type 1 diabetes (T1D). A research team recently tried to assess the effect of celiac disease on growth and glycemic control in patients with T1D, and to determine the effects of a gluten-free diet on these parameters.

The research team included I. Taler, M. Phillip, Y. Lebenthal, L. de Vries, R. Shamir, and S. Shalitin. They are affiliated with the Department of Pediatrics B, Schneider Children's Medical Center of Israel in Petach Tikva, Israel.

To do so, they conducted a longitudinal retrospective case-control study, in which they reviewed the medical data on 68 patients with T1D and duodenal-biopsy-confirmed celiac disease. They looked at weight, height, hemoglobin A1c (HbA1c), frequency of diabetic ketoacidosis (DKA), and severe hypoglycemic events before and after diagnosis and treatment of celiac disease.

They then compared their findings with 131 patients with T1D alone, who were all matched for age, gender, and duration of diabetes.

In all, 5.5% patients with T1D who attended the center during the study period were diagnosed with celiac disease, while 26% of the patients with celiac disease were symptomatic.

The data showed no significant differences in glycemic control or frequency of severe hypoglycemia or DKA events between the study group and control subjects.

Body mass index-standard deviation score (SDS), height-SDS, and HbA1c values were insignificantly higher in the control group than in the study group, and similar in celiac disease patients with good or fair/poor adherence to a gluten-free diet during follow-up.

Patients with T1D and celiac disease and following a gluten-free diet have growth and metabolic control similar to those with T1D with no celiac disease.

To determine whether a gluten-free diet is appropriate for asymptomatic celiac patients or only symptomatic patients must be assessed against possible short- and long-term consequences of no intervention, and the decision should be based on more evidence from larger randomized studies.

Source:

• Open Original Shared Link