Coeliac disease in children with Type 1 diabetes mellitus: the effect of the gluten-free diet.
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.
Sanchez-Albisua
I
I
University Children's Hospital, Tübingen, Germany. soekler.sanchez@t-online.de
Wolf
J
J
Neu
A
A
Geiger
H
H
Wäscher
I
I
Stern
M
M
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001827:Body Height / Q000502:physiology; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy*; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003927:Diet, Diabetic; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007223:Infant; D008297:Male; D010349:Patient Compliance; D015995:Prevalence; D015430:Weight Gain / Q000502:physiology
D001323:Autoantibodies; D006442:Glycated Hemoglobin