Compliance to a Gluten-Free Diet in Swedish Children with Type 1 Diabetes and Celiac Disease

Children with type 1 diabetes (T1D) are at increased risk of celiac disease (CD). The replacement of insulin in T1D, and the exclusion of gluten in CD, are lifelong, burdensome treatments. Compliance to a gluten-free diet (GFD) in children with CD is reported to be high, while compliance in children with both diseases has scarcely been studied. To examine compliance to a GFD in children with both T1D and CD, we analyzed tissue transglutaminase IgA-antibodies (tTGA). Moreover, associations between compliance and age, sex, glycemic control, ketoacidosis (DKA), body mass index (BMI), and time of CD diagnosis were investigated. Of the 743 children diagnosed with T1D in southern Sweden between 2005 and 2012, 9% were also diagnosed with CD. Of these, 68% showed good compliance to a GFD, 18% showed intermediate compliance, and 14% were classified as non-compliant. Higher age, poorer HbA1c, and more DKAs were significantly (p < 0.05) associated with poorer compliance. In conclusion, we found that compliance to a GFD in children with T1D and CD is likely be lower than in children with CD only. Our results indicate that children with both T1D and CD could need intensified dietary support and that older children and children with poor metabolic control are especially vulnerable subgroups.

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High Prevalence of Celiac Disease in Patients with Type 1 Diabetes Detected by Antibodies to Endomysium and Tissue Transglutaminase

Canadian Journal of Gastroenterology ◽

10.1155/2001/640796 ◽

2001 ◽

Vol 15 (5) ◽

pp. 297-301 ◽

Cited By ~ 60

Author(s):

PM Gillett ◽

HR Gillett ◽

DM Israel ◽

DL Metzger ◽

L Stewart ◽

...

Keyword(s):

British Columbia ◽

Type 1 Diabetes ◽

Celiac Disease ◽

Growth Parameters ◽

Morphological Changes ◽

Tissue Transglutaminase ◽

Immunoglobulin A ◽

Gluten Free Diet ◽

Gluten Free

OBJECTIVE: To establish the prevalence of celiac disease (CD) in children with type 1 diabetes in British Columbia.PATIENTS AND METHODS: Two hundred thirty-three children with type 1 diabetes were prospectively screened for CD using blind testing with the current 'gold standard', immunoglobulin A endomysium antibody (EmA), and the novel immunoglobulin A tissue transglutaminase (tTG) antibody. Those children with positive results were offered small bowel biopsy; a gluten-free diet was recommended if CD was confirmed.RESULTS: Nineteen children were positive for EmA and had an elevated tTG level. One patient from this group was already known to have CD, and the other 18 patients consented to biopsy. One biopsy was normal, three biopsies demonstrated elevated intraepithelial lymphocyte counts with normal morphology and 14 biopsies had morphological changes consistent with CD. Growth parameters were normal in all patients, and nine of 19 children who were positive for EmA were asymptomatic. Seven patients had mild elevation of tTG levels alone. Two children from this latter group had normal biopsies, and five declined biopsy.CONCLUSIONS: At least 14 new cases of CD were detected in addition to four known cases, yielding an overall biopsy-confirmed prevalence of CD of 7.7% (18 of 233). The present study confirms that CD is as prevalent in the pediatric type 1 diabetic population in British Columbia as it is in Europe. Serological screening of these children is important because many children have no symptoms or signs suggestive of CD. This study suggests that tTG serology may also be useful in monitoring response and compliance with a gluten-free diet.

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The influence of gluten free diet on quantitative ultrasound of proximal phalanxes in children and adolescents with type 1 diabetes mellitus and celiac disease

Bone ◽

10.1016/j.bone.2008.04.004 ◽

2008 ◽

Vol 43 (2) ◽

pp. 322-326 ◽

Cited By ~ 11

Author(s):

Giuliana Valerio ◽

Raffaella Spadaro ◽

Dario Iafusco ◽

Francesca Lombardi ◽

Antonio del Puente ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Celiac Disease ◽

Type 1 Diabetes Mellitus ◽

Children And Adolescents ◽

Quantitative Ultrasound ◽

Gluten Free Diet ◽

Gluten Free

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Effect of Gluten-Free Diet on Growth and Glycemic Control in Children with Type 1 Diabetes and Asymptomatic Celiac Disease

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem.2010.183 ◽

2010 ◽

Vol 23 (11) ◽

Cited By ~ 2

Author(s):

Vi Lier Goh ◽

D. Elizabeth Estrada ◽

Trudy Lerer ◽

Fabiola Balarezo ◽

Francisco A. Sylvester

Keyword(s):

Type 1 Diabetes ◽

Celiac Disease ◽

Glycemic Control ◽

Gluten Free Diet ◽

Gluten Free

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Design of a dietary intervention to assess the impact of a gluten-free diet in a population with type 1 Diabetes and Celiac Disease

BMC Gastroenterology ◽

10.1186/s12876-015-0413-0 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 7

Author(s):

Esther Assor ◽

Margaret A. Marcon ◽

Natasha Hamilton ◽

Marilyn Fry ◽

Tammy Cooper ◽

...

Keyword(s):

Type 1 Diabetes ◽

Celiac Disease ◽

Dietary Intervention ◽

Gluten Free Diet ◽

Gluten Free ◽

The Impact

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Impact of a Gluten-free Diet on Several Growth Parameters in Children with Type 1 Diabetes Mellitus and Celiac Disease in Western Uttar Pradesh, India

Journal of the ASEAN Federation of Endocrine Societies ◽

10.15605/jafes.031.01.02 ◽

2016 ◽

Vol 31 (1) ◽

pp. 5-9

Author(s):

Manish Gutch ◽

◽

Agrawal Avinash ◽

Kumar Sukriti ◽

Razi Mohd Syed ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Celiac Disease ◽

Type 1 Diabetes Mellitus ◽

Growth Parameters ◽

Uttar Pradesh ◽

Gluten Free Diet ◽

Gluten Free

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Impact of a Gluten-Free Diet on Quality of Life and Health Perception in Patients with Type 1 Diabetes and Asymptomatic Celiac Disease

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa977 ◽

2021 ◽

Author(s):

Daniel I Weiman ◽

Farid H Mahmud ◽

Antoine B M Clarke ◽

Esther Assor ◽

Charlotte McDonald ◽

...

Keyword(s):

Quality Of Life ◽

Type 1 Diabetes ◽

Celiac Disease ◽

Health Perception ◽

Lifestyle Changes ◽

Gluten Free Diet ◽

Gluten Free ◽

Gi Symptoms

Abstract Context Celiac disease (CD) is a common comorbidity seen in patients with type 1 diabetes (T1D) and is frequently asymptomatic. As chronic conditions requiring significant lifestyle changes, there are limited reports assessing changes in health-related quality of life (HRQoL) during transition to a gluten-free diet (GFD) in patients with both T1D and who are asymptomatic for CD. Objective To prospectively assess HRQoL and health perception in children and adults with T1D and asymptomatic CD after randomization to GFD versus usual diet. Design, Setting, and Participants Patients with T1D aged 8-45 years without CD symptoms were serologically screened for CD, with positive results confirmed with intestinal biopsy. Participants were randomized in an open-label fashion to a GFD or gluten-containing diet (GCD) for 12 months. Generic and diabetes-specific HRQoL and self-perceived wellness (SPW) were assessed longitudinally. Results 2,387 T1D patients were serologically screened. CD was biopsy-confirmed in 82 patients and 51 participants were randomized to a GFD (N=27) or GCD (N=24). Excellent adherence to the assigned diets was observed. Overall, no changes in generic (P=0.73) or diabetes-specific HRQoL (P=0.30), or SPW (P=0.41) were observed between groups over 12 months. HemoglobinA1c (HbA1c) and GI symptoms were consistent predictors of HRQoL and SPW. Conclusions HRQoL and SPW were not significantly impacted by the adoption of a GFD over 12 months, but worsened with symptom onset and increased HbA1c. Our findings indicate that transition to a GFD can be made successfully in this population without adversely impacting quality of life.

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Does a gluten-free diet determine the efficacy of sotagliflozin in patients with concomitant type 1 diabetes mellitus and celiac disease?

Gastroenterology Review ◽

10.5114/pg.2018.78291 ◽

2018 ◽

Vol 13 (3) ◽

pp. 249-250

Author(s):

Dimitrios Ioannis Patoulias ◽

Petros Keryttopoulos

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Celiac Disease ◽

Type 1 Diabetes Mellitus ◽

Gluten Free Diet ◽

Gluten Free

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Growth and glycemic control in children with type 1 diabetes and asymptomatic celiac disease treated with a gluten -free diet for 1 year

European Journal of Inflammation ◽

10.1177/2058739219855574 ◽

2019 ◽

Vol 17 ◽

pp. 205873921985557

Author(s):

Maria Giulia Berioli ◽

Giulia Mancini ◽

Nicola Principi ◽

Elisa Santi ◽

Martina Ascenzi ◽

...

Keyword(s):

Type 1 Diabetes ◽

Celiac Disease ◽

Glycemic Control ◽

Gluten Free Diet ◽

Gluten Free ◽

Age And Gender ◽

The Mean ◽

And Gender ◽

Nutritional Status Of Children

To compare growth and glycemic control in children with type 1 diabetes and silent celiac disease treated with a gluten-free diet for 1 year with those of similar age and gender with type 1 diabetes but without celiac disease, 16 type 1 diabetes patients with silent celiac disease were enrolled and each celiac disease-positive case was matched for age, sex, and duration of diabetes with two type 1 diabetes controls with negative serologic markers of celiac disease. All 16 children with positive celiac disease serology had histologic features consistent with celiac disease despite the absence of symptoms. The mean growth and metabolic control values were similar between children with type 1 diabetes and celiac disease and those with type 1 diabetes but without celiac disease. This study seems to suggest that the early diagnosis of celiac disease and initiation of a gluten-free diet may prevent further deterioration in the nutritional status of children with type 1 diabetes and celiac disease and may reduce the prospect of celiac disease complications without any impact on type 1 diabetes control.

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