Coeliac patients detected during type 1 diabetes surveillance had similar issues to those diagnosed on a clinical basis
(2017) In Acta Paediatrica, International Journal of Paediatrics 106(4). p.639-646- 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),... (More)
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.
(Less)
- author
- Laitinen, Anna U. ; Agardh, Daniel LU ; Kivelä, Laura ; Huhtala, Heini ; Lähdeaho, Marja Leena ; Kaukinen, Katri and Kurppa, Kalle
- organization
- publishing date
- 2017
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Clinical diagnosis, Coeliac disease, Routine surveillance, Type 1 diabetes, Villous atrophy
- in
- Acta Paediatrica, International Journal of Paediatrics
- volume
- 106
- issue
- 4
- pages
- 639 - 646
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:27935157
- wos:000397511300020
- scopus:85009729992
- ISSN
- 0803-5253
- DOI
- 10.1111/apa.13695
- language
- English
- LU publication?
- yes
- id
- 77eb09ae-2642-4a26-89b5-e1e982e439d6
- date added to LUP
- 2017-02-01 15:10:22
- date last changed
- 2024-06-14 23:17:44
@article{77eb09ae-2642-4a26-89b5-e1e982e439d6,
abstract = {{<p>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.</p>}},
author = {{Laitinen, Anna U. and Agardh, Daniel and Kivelä, Laura and Huhtala, Heini and Lähdeaho, Marja Leena and Kaukinen, Katri and Kurppa, Kalle}},
issn = {{0803-5253}},
keywords = {{Clinical diagnosis; Coeliac disease; Routine surveillance; Type 1 diabetes; Villous atrophy}},
language = {{eng}},
number = {{4}},
pages = {{639--646}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Paediatrica, International Journal of Paediatrics}},
title = {{Coeliac patients detected during type 1 diabetes surveillance had similar issues to those diagnosed on a clinical basis}},
url = {{http://dx.doi.org/10.1111/apa.13695}},
doi = {{10.1111/apa.13695}},
volume = {{106}},
year = {{2017}},
}