Screening and Treatment Outcomes in Adults and Children With Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study Academic Article uri icon

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abstract

  • OBJECTIVE: To describe celiac disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in patients with type 1 diabetes who are asymptomatic for CD. RESEARCH DESIGN AND METHODS: Asymptomatic patients (8-45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA1c and continuous glucose monitoring over 12 months. RESULTS: Adults had higher CD-seropositivity rates than children (6.8% [95% CI 4.9-8.2%, N = 1,298] vs. 4.7% [95% CI 3.4-5.9%, N = 1,089], P = 0.035) with lower rates of prior CD screening (6.9% vs. 44.2%, P < 0.0001). Fifty-one participants were randomized to a GFD (N = 27) or GCD (N = 24). No HbA1c differences were seen between the groups (+0.14%, 1.5 mmol/mol; 95% CI -0.79 to 1.08; P = 0.76), although greater postprandial glucose increases (4-h +1.5 mmol/L; 95% CI 0.4-2.7; P = 0.014) emerged with a GFD. CONCLUSIONS: CD is frequently observed in asymptomatic patients with type 1 diabetes, and clinical vigilance is warranted with initiation of a GFD.

authors

  • Mahmud, Farid H
  • Clarke, Antoine BM
  • Joachim, Kariym C
  • Assor, Esther
  • McDonald, Charlotte
  • Saibil, Fred
  • Lochnan, Heather A
  • Punthakee, Zubin
  • Parikh, Amish
  • Advani, Andrew
  • Shah, Baiju R
  • Perkins, Bruce A
  • Zuijdwijk, Caroline S
  • Mack, David R
  • Koltin, Dror
  • De Melo, Emilia N
  • Hsieh, Eugene
  • Mukerji, Geetha
  • Gilbert, Jeremy
  • Bax, Kevin
  • Lawson, Margaret L
  • Cino, Maria
  • Beaton, Melanie D
  • Saloojee, Navaaz A
  • Lou, Olivia
  • Gallego, Patricia H
  • Bercik, Premysl
  • Houlden, Robyn L
  • Aronson, Ronnie
  • Kirsch, Susan E
  • Paterson, William G
  • Marcon, Margaret A

publication date

  • July 2020