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Screening and treatment outcomes in adults and children with type 1 diabetes and asymptomatic celiac disease: The CD-DIET study

Diabetes Care, ISSN: 1935-5548, Vol: 43, Issue: 7, Page: 1553-1556
2020
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Celiac disease ‘frequently’ asymptomatic in type 1 diabetes

Celiac disease as a comorbidity of type 1 diabetes is often asymptomatic, and people with both diseases should closely monitor glucose levels during transition to a gluten-free diet, according to a study. “Celiac disease is a disorder triggered by gluten that is frequently unrecognized and asymptomatic, especially in individuals with type 1 diabetes or other autoimmune conditions,” Farid Mahmud, M

Article Description

OBJECTIVE To describe celiac disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in patients with type 1 diabetes who are asymptomatic for CD. RESEARCH DESIGN AND METHODS Asymptomatic patients (8–45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA and continuous glucose monitoring over 12 months. RESULTS Adults had higher CD-seropositivity rates than children (6.8% [95% CI 4.9–8.2%, N 5 1,298] vs. 4.7% [95% CI 3.4–5.9%, N 5 1,089], P 5 0.035) with lower rates of prior CD screening (6.9% vs. 44.2%, P < 0.0001). Fifty-one participants were randomized to a GFD (N 5 27) or GCD (N 5 24). No HbA differences were seen between the groups (10.14%, 1.5 mmol/mol; 95% CI 20.79 to 1.08; P 5 0.76), although greater postprandial glucose increases (4-h 11.5 mmol/L; 95% CI 0.4–2.7; P 5 0.014) emerged with a GFD. CONCLUSIONS CD is frequently observed in asymptomatic patients with type 1 diabetes, and clinical vigilance is warranted with initiation of a GFD.

Bibliographic Details

Mahmud, Farid H; Clarke, Antoine B M; Joachim, Kariym C; Assor, Esther; McDonald, Charlotte; Saibil, Fred; Lochnan, Heather A; Punthakee, Zubin; Parikh, Amish; Advani, Andrew; Shah, Baiju R; Perkins, Bruce A; Zuijdwijk, Caroline S; Mack, David R; Koltin, Dror; De Melo, Emilia N; Hsieh, Eugene; Mukerji, Geetha; Gilbert, Jeremy; Bax, Kevin; Lawson, Margaret L; Cino, Maria; Beaton, Melanie D; Saloojee, Navaaz A; Lou, Olivia; Gallego, Patricia H; Bercik, Premysl; Houlden, Robyn L; Aronson, Ronnie; Kirsch, Susan E; Paterson, William G; Marcon, Margaret A

American Diabetes Association

Medicine; Nursing

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