title: Quality of life in children with diabetes and celiac disease: minimal impact of the 'double diagnosis'.
abstract: BACKGROUND
  Despite the advent of sensitive testing to detect celiac disease (CD), screening in type 1 diabetes (T1D) remains controversial. Many diabetes clinics are apprehensive about the prospect of introducing a second illness requiring intensive lifestyle changes in patients and families already managing a chronic condition, especially in asymptomatic patients.
  
  
  OBJECTIVE
  To determine the impact of managing CD + T1D on quality of life in families, with attention to the effect of adherence with a gluten-free diet (GFD) and metabolic control.
  
  
  METHODS
  Cross-sectional assessment using a validated self-reported quality of life measure: 28 children with biopsy-proven CD + T1D were compared with 40 subjects with T1D aged 8-18 yr. Parental and child reports were assessed as well as symptoms at the time of CD diagnosis and adherence with a GFD at the quality of life assessment.
  
  
  RESULTS
  No significant differences in quality of life were observed between subjects with established CD + T1D and subjects with T1D alone. Parents of children with CD + T1D reported lower social functioning scores than parents of children with T1D (p = 0.03). In the CD + T1D group no differences in quality of life were observed with regard to age at CD diagnosis, CD duration, or on the basis of adherence with a GFD.
  
  
  CONCLUSIONS
  The additional diagnosis of CD has minimal impact on quality of life in children with T1D; however, parents of CD + T1D children did express greater concern about their child's social functioning.
authors.affiliation: Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors.forename: Shama
authors.initials: S
authors.lastname: Sud
authors.forename: Margaret
authors.initials: M
authors.lastname: Marcon
authors.forename: Esther
authors.initials: E
authors.lastname: Assor
authors.forename: Denis
authors.initials: D
authors.lastname: Daneman
authors.forename: Farid H
authors.initials: FH
authors.lastname: Mahmud
mesh_terms: D000293:Adolescent; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000178:diet therapy / Q000188:drug therapy / Q000523:psychology*; D055050:Diet, Gluten-Free; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010349:Patient Compliance / Q000523:psychology; D011788:Quality of Life
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin