[Impact of diagnosis of celiac disease on metabolic control of type 1 diabetes].
OBJECTIVE
To asses the prevalence of celiac disease and to evaluate the clinical effects of a gluten-free diet on metabolic control and growth in children and adolescents with type 1 diabetes mellitus (DM1).


METHODS
We performed a retrospective study of 261 patients with DM1. Diagnosis of celiac disease was based on the presence of endomysium and tissue transglutaminase antibodies in serum and was confirmed by intestinal biopsy. The impact of a gluten-free diet on metabolic control (mean annual HbAlc values), growth (height and annual growth velocity) and nutritional status (body mass index) was evaluated. Patients diagnosed with DM1 and subsequently with celiac disease were compared with a control group of patients with DM1 only.


RESULTS
Twenty-one (8%) of the 261 diabetic patients were diagnosed with celiac disease and 19% also had another associated autoimmune disease. No significant differences were found in growth or metabolic control after withdrawal of gluten from the diet.


CONCLUSIONS
We found a high prevalence of celiac disease in our type 1 diabetes population. A gluten-free diet had no effects on metabolic control of diabetes or on height or weight. Nevertheless, given the high prevalence of celiac disease and the possible development of long-term complications, such as lymphoma and osteoporosis, we recommend systematic screening in all diabetic patients, especially in the first 5 years after diagnosis of DM1.
Nóvoa Medina
Y
Y
Unidad de Diabetes y Gastroenterología Pediátrica, Hospital Universitario Ramón y Cajal, Madrid, España.
López-Capapé
M
M
Lara Orejas
E
E
Alonso Blanco
M
M
Camarero Salces
C
C
Barrio Castellanos
R
R
D000293:Adolescent; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies