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Coeliac disease in children with Type 1 diabetes mellitus: the effect of the gluten‐free diet
Author(s) -
SanchezAlbisua I.,
Wolf J.,
Neu A.,
Geiger H.,
Wäscher I.,
Stern M.
Publication year - 2005
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2005.01609.x
Subject(s) - medicine , coeliac disease , asymptomatic , serology , gastroenterology , gluten free , diabetes mellitus , malabsorption , immunopathology , disease , antibody , endocrinology , immunology
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 .