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Cited by 16Celiac Disease Research and ManagementDiabetes and associated disordersEosinophilic Esophagitis

Coeliac patients detected during type 1 diabetes surveillance had similar issues to those diagnosed on a clinical basis

Laitinen, Anna U., Agardh, Daniel, Kivelä, Laura, Huhtala, Heini, Lähdeaho, Marja‐Leena, Kaukinen, Katri, Kurppa, Kalle·2017·Acta Paediatrica
DOI 10.1111/apa.13695
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Abstract

AIM: Screening children with type 1 diabetes for coeliac disease is controversial, because they often appear asymptomatic. Our aim was to establish whether active screening should be recommended. METHODS: This study focused on 22 children whose coeliac disease was detected by serological screening during diabetes surveillance and 498 children diagnosed because of a clinical suspicion. We compared the clinical and histological data at diagnosis and the children's adherence and responses to a gluten-free diet. RESULTS: The serological screening group suffered less from decreased growth (p = 0.016) and clinical symptoms (p < 0.001) at diagnosis than the clinical group. The groups did not differ in terms of age at diagnosis (p = 0.903), gender (p = 0.353), anaemia (p = 0.886), endomysial antibody titres (p = 0.789) and the severity of small-bowel mucosal atrophy (p = 0.104). They also showed equal adherence (p = 0.086) and clinical responses (p = 0.542) to a gluten-free diet after a median follow-up of 13 months. CONCLUSION: Coeliac patients detected during diabetes surveillance had signs of malabsorption and advanced mucosal damage that was similar to those diagnosed on a clinical basis. They often suffered from unrecognised gluten-dependent symptoms and showed excellent adherence and responses to a gluten-free diet. Our findings support active screening for coeliac disease in patients with type 1 diabetes.

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  • The long-term outcome of celiac disease in type 1 diabetes patients is similar to that in celiac disease without type 1 diabetes in terms of compliance with the gluten-free diet and achieving remission of celiac disease.

    “The long-term outcome of CD in T1D patients is similar to the one in CD without T1D in terms of compliance with the GFD and achieving remission of CD (129, 130).”

    From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [129]

    The Results (p. 9) report similar gluten-free diet adherence and clinical and serological response in the two groups. The paper studied children after a median follow-up of 13 months, so it does not establish a long-term outcome or confirm remission of celiac disease beyond those response measures. The comparison group was clinically diagnosed children, including some with T1D, rather than exclusively children without T1D. (LLM, conf=0.88)

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Authors
Laitinen, A. U., Agardh, D., Kivelä, L., Huhtala, H., Lähdeaho, M., Kaukinen, K., & Kurppa, K.
Affiliations
  • Tampere University Hospital (FI)
  • Lund University (SE)
  • University of Tampere (FI)
Corresponding author
Kurppa, Kalle
ORCID
Venue
Acta Paediatrica
Publisher
Wiley
Published
2017-01-13
Volume
106
Issue
4
Pages
639-646
ISSN
  • 0365-1436 (ISSN-L)
  • 0803-5253
  • 1651-2227
DOI
10.1111/apa.13695
OpenAlex
W2560020681
Cited by
16
References
1
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 1 · 2020: 2 · 2018: 1 · 2017: 3
FWCI
1.46
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Acta Paediatrica (publishedVersion)
  • PubMed (publishedVersion)
  • Tampere University Institutional Repository (Tampere University) (acceptedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
  • Tampere University Institutional Repository (Tampere University) (submittedVersion)
Funders
  • Suomen Akatemia
  • Lastentautien Tutkimussäätiö
  • Suomen Lääketieteen Säätiö
  • Päivikki ja Sakari Sohlbergin Säätiö
Topics
  • Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
Keywords
celiac disease, type 1 diabetes, coeliac screening, serological screening, children, gluten-free diet adherence, anti-endomysial antibodies, anemia, growth retardation, malabsorption, diagnosis
MeSH terms
Adolescent, Celiac Disease, Child, Child, Preschool, Diabetes Mellitus, Type 1, Female, Finland, Humans, Infant, Male, Mass Screening, Cohort Studies

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