Premium
Coeliac patients detected during type 1 diabetes surveillance had similar issues to those diagnosed on a clinical basis
Author(s) -
Laitinen Anna U.,
Agardh Daniel,
Kivelä Laura,
Huhtala Heini,
Lähdeaho MarjaLeena,
Kaukinen Katri,
Kurppa Kalle
Publication year - 2017
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13695
Subject(s) - medicine , coeliac disease , asymptomatic , malabsorption , serology , villous atrophy , gastroenterology , gluten free , diabetes mellitus , disease , type 2 diabetes , antibody , immunology , endocrinology
Aim Screening children with type 1 diabetes for coeliac disease is controversial, because they often appear asymptomatic. Our aim was to establish whether active screening should be recommended. Methods This study focused on 22 children whose coeliac disease was detected by serological screening during diabetes surveillance and 498 children diagnosed because of a clinical suspicion. We compared the clinical and histological data at diagnosis and the children's adherence and responses to a gluten‐free diet. Results The serological screening group suffered less from decreased growth (p = 0.016) and clinical symptoms (p < 0.001) at diagnosis than the clinical group. The groups did not differ in terms of age at diagnosis (p = 0.903), gender (p = 0.353), anaemia (p = 0.886), endomysial antibody titres (p = 0.789) and the severity of small‐bowel mucosal atrophy (p = 0.104). They also showed equal adherence (p = 0.086) and clinical responses (p = 0.542) to a gluten‐free diet after a median follow‐up of 13 months. Conclusion Coeliac patients detected during diabetes surveillance had signs of malabsorption and advanced mucosal damage that was similar to those diagnosed on a clinical basis. They often suffered from unrecognised gluten‐dependent symptoms and showed excellent adherence and responses to a gluten‐free diet. Our findings support active screening for coeliac disease in patients with type 1 diabetes.