Growth and metabolic control in patients with type 1 diabetes and celiac disease: a longitudinal observational case–control study
Article first published online: 7 MAY 2012
© 2012 John Wiley & Sons A/S
Volume 13, Issue 8, pages 597–606, December 2012
How to Cite
Growth and metabolic control in patients with type 1 diabetes and celiac disease: a longitudinal observational case–control study., , , , , .
- Issue published online: 22 NOV 2012
- Article first published online: 7 MAY 2012
- Manuscript Accepted: 12 APR 2012
- Manuscript Revised: 2 APR 2012
- Manuscript Received: 7 JAN 2012
- celiac disease;
- glycemic control;
- type 1 diabetes
The occurrence of celiac disease (CD) in patients with type 1 diabetes (T1D) is increasing.
To determine the effect of CD on growth and glycemic control in patients with T1D, and the effects of adherence to gluten-free diet (GFD) on these parameters.
Patients and methods
A longitudinal retrospective case–control design was used. The medical files of 68 patients with T1D and duodenal-biopsy-confirmed CD were reviewed for data on weight, height, hemoglobin A1c (HbA1c), frequency of diabetic ketoacidosis (DKA), and severe hypoglycemic events before and after diagnosis and treatment of CD. Findings were compared with 131 patients with T1D only matched for age, gender, and duration of diabetes.
CD was diagnosed in 5.5% of all patients with T1D attending our center during the study period; 26% of the patients with CD were symptomatic. There were no significant differences in glycemic control or frequency of severe hypoglycemia or DKA events between the study and control groups. Body mass index-standard deviation score (SDS), height-SDS, and HbA1c values were marginally but not significantly higher in the control than the study group and similar in subjects with CD with good or fair/poor adherence to a GFD throughout follow-up.
Patients with T1D and CD treated with GFD have growth and measures of metabolic control similar to those with T1D without CD. The decision whether asymptomatic celiac patients should be put on a GFD or only symptomatic patients has to be weighed against possible short- and long-term consequences of no intervention, and should be based on more evidence from larger randomized studies.