Maintaining the gluten-free diet: The key to improve glycemic metrics in youths with type 1 diabetes and celiac disease

Enza Mozzillo; Marco Marigliano; Irene Cuccurullo; Federica Berchielli; Renata Auricchio; Claudio Maffeis; Francesco Maria Rosanio; Dario Iafusco; Carlo Pedrolli; Riccardo Pertile; Maurizio Delvecchio; Stefano Passanisi; Giuseppina Salzano; Francesca Di Candia; Roberto Franceschi

doi:10.1016/j.diabres.2023.111074

Maintaining the gluten-free diet: The key to improve glycemic metrics in youths with type 1 diabetes and celiac disease

Diabetes Res Clin Pract. 2024 Jan:207:111074. doi: 10.1016/j.diabres.2023.111074. Epub 2023 Dec 22.

Authors

Affiliations

¹ Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy.
² Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
³ Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.
⁴ Dietology Unit, S. Chiara General Hospital, APSS, Trento, Italy.
⁵ Department of Woman, Child and General and Specialistic Surgery, Regional Center of Pediatric Diabetes, University of Campania "L. Vanvitelli", Naples, Italy.
⁶ Clinical and Evaluative Epidemiology Unit, Department of Governance, APSS, Trento, Italy.
⁷ Metabolic Disorders and Diabetes Unit, "Giovanni XXIII" Children's Hospital, Azienda Ospedaliero-Universitaria (AOU) Policlinico-Giovanni XXIII, Bari, Italy.
⁸ Department of Human Pathology of Adulthood and Childhood G. Barresi, University of Messina, Messina, Italy.
⁹ Department of Translational Medical Science, University of Naples Federico II, Naples, Italy. Electronic address: dicandiafra@gmail.com.
¹⁰ Department of Pediatrics, S. Chiara Hospital of Trento, APSS, Trento, Italy.

PMID: 38142746
DOI: 10.1016/j.diabres.2023.111074

Abstract

Aims: Gluten-free diets (GFD) were considered as high glycemic index and/or high content of saturated fats; this could affect keeping good metabolic control in individuals with both type 1 diabetes (T1D) and celiac disease (CD). Our objective was to analyze time in range and other continuous glucose monitoring (CGM) metrics with real-time CGM systems, in youths with T1D and CD, compared to those with T1D only.

Methods: An observational case-control study, comparing youths aged 8-18 years with T1D and CD, with people with T1D only was performed. The degree of maintaining GFD was assessed through anti-tissue transglutaminase antibodies and dietary interview, and maintaining Mediterranean diet through the KIDMED questionnaire.

Results: 86 youths with T1D and CD, 167 controls with T1D only, were included in the study and the two groups reported similar real-time CGM metrics. Among the first group, 29 % were not completely maintaining GFD and compared to people with T1D only they showed higher hyperglycemia rates (% time above range: 38.72 ± 20.94 vs 34.34 ± 20.94; P = 0.039).

Conclusions: Individuals with T1D and CD who maintain GFD presented similar glucose metrics compared to youths with T1D only. Individuals not strictly maintaining GFD presented higher hyperglycemia rates.

Keywords: Celiac disease; Glucose control; Maintaining GFD; Type1 diabetes mellitus.

Publication types

Observational Study

MeSH terms

Adolescent
Blood Glucose
Blood Glucose Self-Monitoring
Case-Control Studies
Celiac Disease*
Diabetes Mellitus, Type 1*
Diet, Gluten-Free
Humans
Hyperglycemia* / prevention & control

Substances

Blood Glucose