High prevalence of celiac disease among patients with insulin-dependent (type I) diabetes mellitus.
OBJECTIVE
Diagnosis of unrecognized celiac disease is potentially important. The prevalence of celiac disease in patients with insulin-dependent diabetes mellitus is uncertain. We report the prevalence of celiac disease in a stratified random sample (n = 101) of adult insulin-dependent diabetic patients (age, 18-59 yr) attending our clinic, and in an age- and sex-matched control group (n = 51).


METHODS
Screening was by anti-endomysial antibody, measured by indirect immunofluorescence using sections of human umbilical cord.


RESULTS
Celiac disease had not been suspected in any patient at the time of screening. Eight patients tested positive for anti-endomysial antibody, all of whom had a distal duodenal biopsy performed. Five patients had histologic evidence of celiac disease. One patient with negative histology was receiving immunosuppressive therapy for a renal-pancreas transplant. Of the five patients with abnormal histology, two improved on gluten restriction, one was unable to comply, one refused treatment, and one was lost to follow-up. No control subject tested positive for endomysial antibody.


CONCLUSIONS
Patients with insulin-dependent diabetes have an increased prevalence of celiac disease. Because most cases are clinically unrecognized, consideration should be given to screening all insulin-dependent diabetes mellitus patients with endomysial antibodies.
Cronin
C C
CC
Department of Medicine, National University of Ireland, Cork.
Feighery
A
A
Ferriss
J B
JB
Liddy
C
C
Shanahan
F
F
Feighery
C
C
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy / Q000276:immunology / Q000473:pathology; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D018753:Diet, Protein-Restricted; D004378:Duodenal Diseases / Q000473:pathology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009210:Myofibrils / Q000276:immunology; D016035:Pancreas Transplantation / Q000276:immunology; D010352:Patient Dropouts; D015995:Prevalence; D016312:Treatment Refusal
D007166:Immunosuppressive Agents; D005983:Glutens