Coeliac disease in children with Type 1 diabetes mellitus: the effect of the gluten-free diet

Diabet Med. 2005 Aug;22(8):1079-82. doi: 10.1111/j.1464-5491.2005.01609.x.

Abstract

Patients and methods: We assessed the frequency of coeliac disease in 281 children with Type 1 diabetes and the effect of gluten-free diet (GFD) in newly diagnosed cases. Serological screening was performed using anti-gliadin and anti-endomysium antibodies. Data were obtained about clinical symptoms, height and weight-for-height.

Results: A small intestinal biopsy was recommended to 18 patients (6.4%) with positive serological results and 12 children agreed. Nine of them had coeliac disease. Three out of nine coeliac children complained about gastrointestinal symptoms. On a GFD, the symptoms disappeared in two patients. Iron-deficiency anaemia was present in four subjects and disappeared in the three patients who accepted the GFD. In three patients (33%), coeliac disease was asymptomatic. Height and weight-for-height were in the normal range for all patients. For well-complying patients, there was a significant increase in height standard deviation at diagnosis and on follow-up (-0.28 vs. +0.35) (P = 0.03). Changes in weight-for-height were not significant (-4.0% vs. +1.4%) (P = 0.28). There was a trend to an improvement in HbA(1c) (8.0 vs. 7.3%) (P = 0.05).

Conclusions: Serological screening is effective. There is a therapeutic benefit for some screening-detected patients, but confirmatory studies are needed.

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / blood
  • Body Height / physiology
  • Celiac Disease / complications
  • Celiac Disease / diet therapy*
  • Child
  • Child, Preschool
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diet, Diabetic*
  • Female
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Infant
  • Male
  • Patient Compliance
  • Prevalence
  • Weight Gain / physiology

Substances

  • Autoantibodies
  • Glycated Hemoglobin A