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Coeliac disease, gluten-free diet and the development and progression of albuminuria in children with type 1 diabetes: Coeliac disease and type 1 diabetes
Open accessAbstract
OBJECTIVES: Although a diagnosis of coeliac disease (CD) may be confronting to children with type 1 diabetes and their families, we hypothesize that children with CD have lower urinary albumin excretion, a marker of renal dysfunction. RESEARCH DESIGN: Twenty-four children with type 1 diabetes and biopsy-proven CD, on a gluten-free diet for at least 1 yr, were recruited from a single paediatric diabetes clinic alongside 55 children with type 1 diabetes but without CD matched for age, gender, duration of diabetes, and glycaemic control. RESULTS: Despite comparable diabetes exposure, glycaemic control and nutritional status, children with type 1 diabetes and CD had a lower urinary albumin creatinine ratio than in diabetic subjects without CD (0.9 ± 0.3 mg/mmol vs. 1.6 ± 0.3 mg/mmol; p = 0.01). Participants with CD also showed slower progression in albuminuria over 5-yr of follow-up while a small but significant increase was observed in the children with diabetes alone (1.6 ± 0.3 mg/mmol; follow-up 2.4 ± 0.5 mg/mmol; p = 0.02). CONCLUSIONS: As urinary albumin excretion is continuously associated with the risk of kidney disease, it is possible to speculate that CD or its management confers a degree of renoprotection. Larger studies are required to test this hypothesis.
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The risk of fractures and nephropathy was not found to be higher in patients with both celiac disease and type 1 diabetes compared to isolated type 1 diabetes.
“On the other hand, the risk of fractures and nephropathy was not found to be higher in patients with both CD and T1D compared to isolated T1D (125, 128, 131).”
From ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease. (2022) · cites this paper as [131]
The Results and Discussion report lower albuminuria and slower progression of urinary albumin excretion in children with both coeliac disease and type 1 diabetes than in matched children with type 1 diabetes alone. This supports the kidney-related direction of the claim, but the paper does not report fracture risk or establish a difference in clinical nephropathy risk; it describes renoprotection as a possibility requiring larger studies. (LLM, conf=0.88)
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Research works printed but not linked: 8
- Volta, 2011, Clinical and immunological features of celiac disease in patients with type 1 diabetes mellitus, Expert Rev Gastroenterol Hepatol, 5, 479, 10.1586/egh.11.38 · DOI
- Malalasekera, 2009, Potential reno-protective effects of a gluten-free diet in type 1 diabetes, Diabetologia, 52, 798, 10.1007/s00125-009-1277-z · DOI
- Thomas, 2011, Soluble receptor for AGE (RAGE) is a novel independent predictor of all-cause and cardiovascular mortality in type 1 diabetes, Diabetologia, 54, 2669, 10.1007/s00125-011-2186-5 · DOI
- Watson, 2012, Alagebrium reduces glomerular fibrogenesis and inflammation beyond preventing RAGE activation in diabetic apolipoprotein E knockout mice, Diabetes, 61, 2105, 10.2337/db11-1546 · DOI
- Stone, 2006, Natural history and risk factors for microalbuminuria in adolescents with type 1 diabetes: a longitudinal study, Diabetes Care, 29, 2072, 10.2337/dc06-0239 · DOI
- Cordovado, 2008, Nephropathy in type 1 diabetes is diminished in carriers of HLA-DRB1*04: the genetics of kidneys in diabetes (GoKinD) study, Diabetes, 57, 518, 10.2337/db07-0826 · DOI
- Forbes, 2003, Role of advanced glycation end products in diabetic nephropathy, J Am Soc Nephrol, 14, S254, 10.1097/01.ASN.0000077413.41276.17 · DOI · Paper page
- Vlassara, 2007, Glycotoxins in the diet promote diabetes and diabetic complications, Curr Diab Rep, 7, 235, 10.1007/s11892-007-0037-z · DOI
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ESPGHAN Position Paper on Management and Follow-up of Children and Adolescents With Celiac Disease.
Mearin, M. L., Agardh, D., Antunes, H., Al‐toma, A., Auricchio, R., Castillejo, G., Catassi, C., Ciacci, C., Discepolo, V., Dolinsek, J., et al. (2022) · Journal of pediatric gastroenterology and nutrition · doi:10.1097/mpg.0000000000003540 · Cited by 186
Metadata
- Authors
- Gopee, E., van den Oever, E. L., Cameron, F., & Thomas, M. C.
- Affiliations
- Royal Children's Hospital (AU)
- Baker Heart and Diabetes Institute (AU)
- Corresponding author
- Thomas, Merlin C
- Venue
- Pediatric Diabetes
- Publisher
- Hindawi Limited
- Published
- 2013-06-14
- Volume
- 14
- Issue
- 6
- Pages
- 455-458
- ISSN
- 1399-543X (ISSN-L)
- OpenAlex
- W1486766220
- Cited by
- 18
- References
- 0
- Citations by year
- 2025: 2 · 2024: 1 · 2022: 2 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 2 · 2015: 3 · 2014: 2 · 2013: 1
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Pediatric Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- celiac disease, gluten-free diet, type 1 diabetes, children, albuminuria, urinary albumin excretion, albumin-creatinine ratio, diabetic nephropathy, renal dysfunction, renal protection, disease progression
- MeSH terms
- Adolescent, Albuminuria, Celiac Disease, Child, Child Development, Diabetes Mellitus, Type 1, Diabetic Nephropathies, Disease Susceptibility, Female, Follow-Up Studies, Hospitals, Pediatric, Humans, Kidney, Male, Prospective Studies, Risk Factors, Victoria, Biomarkers, Disease Progression, Adolescent Development, Renal Insufficiency, Diet, Gluten-Free
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