title: Potential coeliac disease in Type 1 diabetes mellitus: does a positive antibody lead to increased complications?
abstract: OBJECTIVE
  Coeliac disease (CD) is more common in people with Type 1 diabetes and is associated with poorer glycaemic control, lipid profiles, nephropathy and retinopathy. Potential CD (positive serology but normal duodenal biopsy) is associated with neuropathy but patients with coexisting Type 1 diabetes were excluded. The aim was to determine whether potential CD is associated with increased microvascular complications in patients with Type 1 diabetes.
  
  
  RESULTS
  Four groups were recruited; 1) patients with Type 1 diabetes and potential CD, 2) patients with Type 1 diabetes and newly identified CD, 3) patients with Type 1 diabetes alone and 4) patients with CD alone. Glycaemic control, quality of life, lipid profile and microvascular complication rates were examined. As many as 76 individuals were included in the study: 22 in group 1, 14 in group 2, 24 in group 3 and 16 in group 4. There were no differences in age, gender, BMI and diabetes duration between the groups. Patients in group 1 had significantly lower total cholesterol compared to group 3 (p = 0.003) but higher than group 2 (p = 0.027). There were no significant differences in HbA1c, HDL cholesterol, cholesterol:HDL ratio, creatinine, quality of life scores or prevalence of neuropathy between individuals in group 1 and the other groups.
  
  
  CONCLUSIONS
  This is the first study to assess the effects of potential CD in patients with Type 1 diabetes. It appears that an enteropathy is required as well as antibody positivity in order to increase the risk of diabetes related complications. This pilot data requires further longitudinal validation.
authors.affiliation: Gastroenterology & Liver Unit, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. Electronic address: j.leeds@nhs.net.
authors.forename: J S
authors.initials: JS
authors.lastname: Leeds
authors.affiliation: Gastroenterology & Liver Unit, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Hopper
authors.affiliation: Department of Neurology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: M
authors.initials: M
authors.lastname: Hadjivassiliou
authors.affiliation: Department of Diabetes, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: S
authors.initials: S
authors.lastname: Tesfaye
authors.affiliation: Gastroenterology & Liver Unit, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK.
authors.forename: D S
authors.initials: DS
authors.lastname: Sanders
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002446:Celiac Disease / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D003925:Diabetic Angiopathies; D003929:Diabetic Neuropathies / Q000209:etiology; D004386:Duodenum / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015995:Prevalence; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012698:Serologic Tests; D055815:Young Adult
chemical_list: D000906:Antibodies; D015415:Biomarkers; D002784:Cholesterol; D003404:Creatinine
keywords: Coeliac disease; Complications; Glycaemic control; Type 1 diabetes