Prevalence and clinical profile of celiac disease in type 1 diabetes mellitus in north India.
OBJECTIVE
There is scanty data on the occurrence of celiac disease in patients with type 1 diabetes mellitus in South Asia. Our aim was to study the prevalence and clinical profile of celiac disease in patients with type 1 diabetes mellitus in a tertiary care referral centre in north India.


METHODS
Consecutive patients of type 1 diabetes mellitus attending the Endocrine clinic of our institute between January 2002 and December 2008 were screened using anti-tissue transglutaminase antibodies (tTGAb), and those positive were subjected to duodenal biopsy. Clinical profile of these patients was recorded.


RESULTS
Out of 189 patients of type 1 diabetes mellitus, 21 (11.1%) were diagnosed to have celiac disease on the basis of positive serology (tTGAb) and duodenal histology. The mean age at diagnosis of diabetes was 10.81 ± 7.3 years and that of celiac disease was 13.74 ± 5.71 years, with a difference of 5.18 ± 4.75 years between the two. Only 2/21 patients with celiac disease had been diagnosed before detection of diabetes mellitus. Short stature was the commonest (52.3%) manifestation of celiac disease, followed by anemia (47.3), weight loss (42.8%), diarrhea (28.6%) and abdominal pain (14.2%). After initiating gluten free diet, 14/16 symptomatic patients had reversal of anemia, weight loss and diarrhea. Growth rate velocity improved from 2.3 ± 1.0 cm/year to 5.5 ± 2.4 cm/year in those with short stature.


CONCLUSIONS
Celiac disease is highly prevalent in patients with type 1 diabetes mellitus (11.1%) and majority of them (90.5%) were diagnosed on screening. Routine screening is required for early diagnosis and combat associated co-morbidities.
Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Sanjay Kumar
SK
Bhadada
Rakesh
R
Kochhar
Anil
A
Bhansali
Usha
U
Dutta
Padala R
PR
Kumar
Kuchhangi S
KS
Poornachandra
Kim
K
Vaiphei
Chander K
CK
Nain
Kartar
K
Singh
D015746:Abdominal Pain / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000178:diet therapy / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003967:Diarrhea / Q000453:epidemiology; D055050:Diet, Gluten-Free; D004384:Duodenoscopy; D004386:Duodenum / Q000473:pathology; D042241:Early Diagnosis; D005260:Female; D019204:GTP-Binding Proteins; D006130:Growth Disorders / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012189:Retrospective Studies; D013997:Time Factors; D011503:Transglutaminases / Q000276:immunology; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
D001323:Autoantibodies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins