Advanced

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

Laitinen, Anna U.; Agardh, Daniel LU ; Kivelä, Laura; Huhtala, Heini; Lähdeaho, Marja Leena; Kaukinen, Katri and Kurppa, Kalle (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)
Please use this url to cite or link to this publication:
author
organization
publishing date
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 Publishing Ltd
external identifiers
  • scopus:85009729992
  • wos:000397511300020
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
2018-01-07 11:47:43
@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 &lt; 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},
  keyword      = {Clinical diagnosis,Coeliac disease,Routine surveillance,Type 1 diabetes,Villous atrophy},
  language     = {eng},
  number       = {4},
  pages        = {639--646},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  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},
  volume       = {106},
  year         = {2017},
}