Coeliac disease in children and adolescents with IDDM: clinical characteristics and response to gluten-free diet

Acerini, Carlo L.; Ahmed, Marion L.; Ross, Karen M.; Sullivan, Peter B.; Bird, Geoffrey; Dunger, David B.

doi:10.1002/(sici)1096-9136(199801)15:1<38::aid-dia520>3.0.co;2-l

Cited by 129 publications

(119 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This difference could be explained by the fact that in our Department there is a centre of Paediatric Gastroenterology, which has in follow-up a very large number of patients with coeliac disease. Even though sex was not a factor in our noncoeliac, diabetic cohort, in accordance with what usually occurs in Type I diabetic patients, a higher female preponderance has been found in our CD + T1DM + patients, confirming previous reports on diabetic patients with either coeliac disease [4] or autoimmune thyroid disease [10,11].…”

Section: Discussionsupporting

confidence: 92%

“…betes mellitus (T1DM) ranges from 1.1 to 7.8%, depending on different screening methods and whether adult or paediatric patients were examined [2,3,4]. The pathogenetic mechanism underlying the simultaneous occurrence of these clustered autoimmune diseases has not been clearly elucidated, even though there is evidence that a common genetic determinant could be involved.…”

Section: :1719-1722]mentioning

confidence: 99%

See 1 more Smart Citation

Severe clinical onset of diabetes and increased prevalence of other autoimmune diseases in children with coeliac disease diagnosed before diabetes mellitus

et al. 2002

View full text Add to dashboard Cite

Aims/hypothesis. To analyse whether the time of diagnosis of coeliac disease with respect to the clinical onset of diabetes could differentiate subgroups of varying severity in patients with both diseases.\ud \ud Methods. We investigated 383 patients with Type I (insulin-dependent) diabetes mellitus for coeliac disease. Sex distribution, age at diagnosis of diabetes, prevalence of ketoacidosis at the onset of diabetes and prevalence of other autoimmune diseases were compared in patients. We divided these patients according to whether coeliac disease was diagnosed before (Group A, n=8) or after (Group B, n=24) diabetes onset and whether they had presented clinical symptoms of coeliac disease. Group C (n=351) included diabetic patients without coeliac disease.\ud \ud Results. Out of 383 Type I diabetic patients we found 32 coeliac subjects (8.3%). There was a higher number of girls (p=0.003), but similar age and prevalence of ketoacidosis compared with Group C; 18.7% had a third autoimmune disorder. The higher number of girls was confirmed in Groups A and B in comparison to Group C (p=0.013), while higher prevalence of both ketoacidosis (p=0.009) and other autoimmune diseases (p=0.001) was found only in Group A. Compared with symptomatic patients, asymptomatic subjects in Group B had a lower number of girls, older age at diabetes onset, lower prevalence of ketoacidosis and no other associated autoimmune disease.\ud \ud Conclusions/interpretation. A wide clinical spectrum characterises the association of coeliac disease and diabetes mellitus, with a severe clinical presentation (higher prevalence of ketoacidosis at the onset and occurrence of other autoimmune diseases) when coeliac disease is diagnosed before diabetes. Distinct phenotypes might imply the contribution of a peculiar genetic background

show abstract

Section: Discussionsupporting

confidence: 92%

Section: :1719-1722]mentioning

confidence: 99%

Severe clinical onset of diabetes and increased prevalence of other autoimmune diseases in children with coeliac disease diagnosed before diabetes mellitus

et al. 2002

View full text Add to dashboard Cite

show abstract

“…Saadah et al [28] observed that a GFD resulted in a significant improvement of growth and influenced diabetic control (more insulin in celiac disease patients when compared to baseline). Other authors [26,29] did not find any significant difference in insulin dose, HbA1c, 24 h urinary glucose excretion, or number of hypoglycemic episodes. Similar findings have been observed in adult patients with type 1 diabetes and celiac disease [30] .…”

Section: Glycemic Control In Children With Type 1 Diabetes and Celiacmentioning

confidence: 86%

“…However, a link between a change in body mass index and a possible improvement of metabolic control remains controversial. Acerini et al [26] observed an improvement both in body mass index and in HbA1c, while Nóvoa Medina et al [27] , who studied only type 1 diabetes patients with symptomatic celiac disease, did not find any effects on metabolic control or on height or weight.…”

Section: Glycemic Control In Children With Type 1 Diabetes and Celiacmentioning

confidence: 99%

Type 1 diabetes and celiac disease: The effects of gluten free diet on metabolic control

Scaramuzza

Mantegazza²,

Bosetti³

et al. 2013

WJD

View full text Add to dashboard Cite

Type 1 diabetes mellitus is associated with celiac disease, with a prevalence that varies between 0.6% and 16.4%, according to different studies. After a diagnosis of celiac disease is confirmed by small bowel biopsy, patients are advised to commence a gluten-free diet (GFD). This dietary restriction may be particularly difficult for the child with diabetes, but in Europe (and in Italy) many food stores have targeted this section of the market with better labeling of products and more availability of specific GFD products. Treatment with a GFD in symptomatic patients has been shown to improve the symptoms, signs and complications of celiac disease. However, the effects of a GFD on diabetic control are less well established. Initial reports of improved hypoglycemic control were based on children who were diagnosed with celiac disease associated with malabsorption, but there have subsequently been reports of improvement in patients with type 1 diabetes with subclinical celiac disease. There are other studies reporting no effect, improved control and an improvement of hypoglycemic episodes. Moreover, in this review we wish to focus on low glycemic index foods, often suggested in people with type 1 diabetes, since they might reduce postprandial glycemic excursion and enhance longterm glycemic control. In contrast, GFD may be rich in high glycemic index foods that can increase the risk of obesity, insulin resistance and cardiovascular disease, worsening the metabolic control of the child with diabetes. Hence, it is important to evaluate the impact of a GFD on metabolic control, growth and nutritional status in children with type 1 diabetes.

show abstract

“…[7][8][9] A number of earlier hypotheses with some supporting evidence have been put forward to explain the possible mechanism of action of the environmental trigger including b-cell death secondary to virally triggered inflammation, molecular mimicry, superantigens and diet. [10][11][12][13][14][15][16][17][18][19] What is certain is that at some point postnatally, the immune system of a genetically predisposed individual is activated to infiltrate chronically the islets of Langerhans. While the initial phase of infiltration may not involve b-cell destruction, a number of studies in vivo and in vitro suggest that immune cells become able to render b-cells dysfunctional through the actions of cytokines they produce such as interleukin-1b.…”

Section: Type I Diabetes Mellitus: the Autoimmune Processmentioning

confidence: 99%

Gene- and cell-based therapeutics for type I diabetes mellitus

et al. 2003

View full text Add to dashboard Cite

Coeliac disease in children and adolescents with IDDM: clinical characteristics and response to gluten-free diet

Cited by 129 publications

References 7 publications

Severe clinical onset of diabetes and increased prevalence of other autoimmune diseases in children with coeliac disease diagnosed before diabetes mellitus

Severe clinical onset of diabetes and increased prevalence of other autoimmune diseases in children with coeliac disease diagnosed before diabetes mellitus

Type 1 diabetes and celiac disease: The effects of gluten free diet on metabolic control

Gene- and cell-based therapeutics for type I diabetes mellitus

Contact Info

Product

Resources

About