Objectives : The prevalence of celiac disease (CD) in children with diabetes mellitus type 1(DM1) is 1.6 – 12.3%. usually CD is suspected by screening tests in asymptomatic patients. It is recommended to perform periodic tests, but there is no scientific basis for the frequency of performance of such tests. The purpose of this study was to investigate the incidence of the appearance of CD in children with DM1.
Methods: All celiac antibody screening tests and small bowel biopsy results taken from 1998 until 2015 were obtained. The prevalence of celiac antibodies and the yearly incidence following the diagnosis of DM1 was examined.
Results: 31 children (9.87%, 95% CI 6.8-13.7 had positive celiac antibodies. 25 underwent biopsy. 16 were positive, 7 negative and 2 were inconclusive. In 6 biopsy was not performed, 2 of whom were diagnosed because of high levels (X10 normal) of antibodies, in 3 there was a spontaneous normalization of celiac antibodies with no dietary treatment, and 1 was lost to follow-up. 18/31 subjects were diagnosed with CD (5.73%, 95%, CI 2.7-7.8), 3 were diagnosed at initial diagnosis of DM1. No CD was diagnosed after 5.3 years since the DM1 onset. In the celiac group, the age of diagnosis of DM1 was 7.22 Vs 9.78 years in the non-celiac group (p=0.02).
Conclusion: This study shows that screening for CD is recommended at diagnosis of DM1 and there after yearly for the following 5 years only. There is no benefit for screening after 5 years after diagnosis of DM1. Early age of diagnosis of DM1 is a risk factor for developing CD.
