title: Type 1 and type 2 diabetes in celiac disease: prevalence and effect on clinical and histological presentation.
abstract: BACKGROUND
  Association between celiac disease and type 1 diabetes in adults is still somewhat unclear, and that between celiac disease and type 2 diabetes even less known. We studied these issues in a large cohort of adult celiac disease patients.
  
  
  METHODS
  The prevalence of type 1 and type 2 diabetes in 1358 celiac patients was compared with the population-based values. Furthermore, patients with celiac disease and concomitant type 1 or type 2 diabetes and those with celiac disease only underwent comparisons of clinical and histological features and adherence to gluten-free diet.
  
  
  RESULTS
  The prevalence of type 1 diabetes (men/women) was 8.0 % /1.8 % in celiac patients and 0.7 % /0.3 % in the population, and that of type 2 diabetes 4.3 % /2.5 % and 4.4 % /3.0 %, respectively. Celiac patients with concomitant type 1 diabetes were younger (45 years vs 65 years and 52 years, P < 0.001) and more often screen-detected (43 % vs 13 % and 14 %, P < 0.001), had less other gastrointestinal diseases (8 % vs 40 % and 25 %, P = 0.028), more thyroidal diseases (18 % vs 16 % and 13 %, P = 0.043) and lower dietary adherence (71 % vs 95 % and 96 %, P < 0.001) compared with celiac patients with concomitant type 2 diabetes and patients with celiac disease only. Patients with concomitant type 2 diabetes had more hypercholesterolemia than the other groups (8 % vs 6 % and 4 %, P = 0.024), and both diabetes groups more hypertension (47 % and 31 % vs 15 %, P < 0.001) and coronary artery disease (29 % and 18 % vs 3 %, P < 0.001) than the patients with celiac disease only.
  
  
  CONCLUSIONS
  Type 1 diabetes was markedly overrepresented in celiac disease, especially in men, whereas the prevalence of type 2 diabetes was comparable with the population. Concomitant type 1 or type 2 diabetes predisposes celiac patients to severe co-morbidities and type 1 diabetes also to poor dietary adherence.
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Kylökäs
authors.affiliation: School of Medicine, University of Tampere, Tampere, Finland.|Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
authors.affiliation: Tampere School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.affiliation: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
authors.affiliation: Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Biokatu 10, 33520, Tampere, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Mäki
authors.affiliation: Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Biokatu 10, 33520, Tampere, Finland. kalle.kurppa@uta.fi.
authors.forename: Kalle
authors.initials: K
authors.lastname: Kurppa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000178:diet therapy / Q000453:epidemiology* / Q000473:pathology; D015897:Comorbidity; D048909:Diabetes Complications / Q000453:epidemiology; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D055050:Diet, Gluten-Free; D004386:Duodenum / Q000473:pathology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D015995:Prevalence; D055815:Young Adult
keywords: Celiac disease; Co-morbidity; Type 1 diabetes; Type 2 diabetes