Prevalence of celiac disease in adult type 1 patients with diabetes

Doğan, Burcu; Öner, Can; Bayramiçli, Oya Uygur; Yorulmaz, Elif; Feyizoğlu, Güneş; Oğuz, Aytekin

doi:10.12669/pjms.314.7206

Cited by 9 publications

(12 citation statements)

References 21 publications

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“…It is reported that celiac disease occurs in 2%-3% of T1DM cases. 20 Celiac disease may lead to suspicion of MODY, as it reduces insulin requirement in some T1DM cases. 21 As far as we can determine, there is no comprehensive study on the association of autoimmune endocrine disorders, including celiac disease, in MODY.…”

Section: Discussionmentioning

confidence: 99%

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Clinical and laboratory clues of maturity‐onset diabetes of the young and determination of association with molecular diagnosis

Karaoğlan

Nacarkahya

2020

Journal of Diabetes

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Background/Aim: Maturity-onset diabetes of the young (MODY) is often misdiagnosed as other types of diabetes because it is overlooked due to atypical clinical presentations. This study aims to reveal the clinical and laboratory clues and examine their compatibility with MODY genotypes. Methods: Participants consisted of 230 children with atypical presentations for type1(T1DM) and type2 diabetes mellitus (T2DM). MODY-causing mutations were screened in the following genes:GCK-HNF1A-HNF4A-HNF1B-PDX1-NEUROD1-KLF11-CEL-PAX4-INS-BLK. Clinical and laboratory features were compared between children with MODY and children without MODY. Results: The most common reasons for MODY screening were as follows (n/%):low daily dose of insulin (DDI) requirement (122/53%), absence of betacell antibodies(58/25.3%), coincidental hyperglycemia(26/11.3%), family history of diabetes (12/5.2%), hypoglycemia/hyperglycemia episodes(7/3%), hyperglycemia related to steroids(3/1.4%) and renal glycosuria(2/0.8%). The markers with the most likelihood to distinguish MODY from T1DM were determined as follows: measurable C-peptide in follow-up, family history of early-onset diabetes and low DDI requirement (odds ratio:12.55, 5.53 and 3.43, respectively). The distribution of the most common causative genes in children with MODY(n = 24) is as follows (n/%):GCK(15/62.5%), HNF4A(7/29.1%), HNF1A (1/9.2%) and PDX1(1/9.2%).All children(n = 12) with GCK-MODY(MODY2) were screened for low DDI requirement, while beta-cell negativity was more common in HNF4A-MODY(MODY1). Conclusion: The study shows that measurable C-peptide in follow-up, family history of early-onset diabetes, and low DDI are still remarkable clues to predict MODY in children with misdiagnosed T1DM. In addition, the most common mutations were found in the GCK and HNF4A genes. Among children misdiagnosed with T1DM, a low DDI requirement was found more frequently in MODY2, whereas beta-cell antibody negativity was more common in MODY1.

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Section: Discussionmentioning

confidence: 99%

“…One of the interesting and important findings in our study is the high seropositivity rate (12.5%) for anti‐tTg in children with MODY. It is reported that celiac disease occurs in 2%‐3% of T1DM cases 20 . Celiac disease may lead to suspicion of MODY, as it reduces insulin requirement in some T1DM cases 21 …”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory clues of maturity‐onset diabetes of the young and determination of association with molecular diagnosis

Karaoğlan

Nacarkahya

2020

Journal of Diabetes

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“…The prevalence of definite CD in this study is similar to that reported in T1DM patients from other countries including Turkey (2.3%) and France (1.6%). [22][23][24] Information from sub-Saharan Africa (SSA) is scanty and has been highlighted by Catassi et al, who identified this region as a "black hole" in the world map of CD prevalence, 5 with a call for research in apparently "celiac free" regions such as SSA and the Far-East. 25 Data from North African countries (Egypt, Libya, and Tunisia) report prevalence rates of 4-10.3%, which is similar or even higher than in Caucasians.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and characteristics of celiac disease in South African patients with type 1 diabetes mellitus: Results from the Durban Diabetes and Celiac Disease Study

Paruk

Naidoo

Pirie

et al. 2019

J of Gastro and Hepatol

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Background and Aim The aim of this study was to assess the prevalence and characteristics of celiac disease (CD) in all patients with type 1 diabetes mellitus attending a tertiary adult diabetes clinic in Durban, South Africa. Methods This was a cross‐sectional observational study that screened 202 patients; of these, 56.4% were African (Black), 31.7% Asian Indian, 4.5% White, and 7.4% mixed race. Demographic data, symptoms, and anthropometry were documented. Blood tests included anti‐tissue transglutaminase antibody (tTG), anti‐endomysial antibody (EMA), and anti‐gliadin antibody (AGA). Endoscopy and duodenal biopsy were performed in patients with celiac antibodies. Diagnosis of CD was based on the modified Marsh classification. Results Mean age and mean duration of diabetes were 26.4 ± 11.4 and 10.7 ± 9.1 years, respectively. Celiac antibodies were found in 65 (32.2%) patients: EMA 7.4%, tTG immunoglobulin A (IgA) 8.4%, tTG immunoglobulin G 1.9%, AGA IgA 18.3%, and AGA immunoglobulin G 21.8%. Histological evidence of CD was found in 5.9% (n = 12/202): 2.5% were classed as definite CD (Marsh 3) and 3.4% as potential CD (Marsh 1). None of the patients with CD were symptomatic. The sensitivity of AGA IgA, EMA, and tTG IgA antibodies for detecting histologically proven CD was 66.7%, 50.0%, and 41.7%, respectively. Conclusion The prevalence of CD was similar to reports from western countries. No ethnic specific differences were noted. CD was silent in all patients in this study. The sensitivity of EMA and tTG antibodies was poor and merits further evaluation as screening tools for CD in South African patients with type 1 diabetes mellitus.

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“…The prevalence of CD ranges from 2-3% in Finland and Sweden to only 0.2% in Germany [90], and this is similar to the prevalence of CD in the general population of the Asian-Pacific region. The prevalence of CD in diabetes mellitus type 1 (DM1) patients in Western countries has been reported between 1-12% [91], and is quite similar to that in the Asia-Pacific region, which reported a prevalence of CD between 2.3%-11.3% in DM1 patients [33][34][35][36][37][38][39][40][41][42]. The CD prevalence in DM1 patients was significantly higher in children compared to adults (6% vs. 2.5%; P<0.05) in the Asia-Pacific region.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of gluten-related disorders in Asia-Pacific region: a systematic review

Ashtari

Pourhoseingholi

Rostami

et al. 2019

JGLD

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Background & Aims: The epidemiology of gluten-related disorders (GRDs) is still an open field to be explored. We conducted this systematic review based on the current epidemiology knowledge of GRDs, focusing on the changing prevalence of GRDs reported in the Asia-Pacific region.Methods: We searched Medline, PubMed, Scopus, Web of Science and Cochrane database with the following MeSH terms and keywords: celiac disease (CD), wheat allergy (WA), non-celiac gluten sensitivity (NCGS), dermatitis herpetiformis (DH) and gluten ataxia (GA) and the prevalence studies published from January 1991 to January 2018. Each article was cross-referenced with “Asia-Pacific region” and countries in this regionsuch as Australia, New Zealand, India, Pakistan, Turkey, Iran and others.Results: We included 66 studies, which reported the prevalence of GRDs in the Asia-Pacific region. Prevalence of celiac disease was 0.32%-1.41% in healthy children and 0.05%-1.22% in the adult population, while the prevalence in the high risk population was higher (0.6%-11.8%). Previous studies have shown a very low incidence of dermatitis herpetiformis (DH) (<0.001%) and gluten ataxia (GA) in this area. Few studies on NCGS outbreaks have been found in this area due to the lack of specific diagnostic biomarkers. Wheat allergy (WA), although uncommon in most Asian-Pacific countries, is the most common cause of anaphylaxis in this region.Conclusion: The results of this systematic review suggest the need to plan further proper epidemiological studies in order to understand the natural history of GRDs and to assess its burden on health systems.

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Prevalence of celiac disease in adult type 1 patients with diabetes

Cited by 9 publications

References 21 publications

Clinical and laboratory clues of maturity‐onset diabetes of the young and determination of association with molecular diagnosis

Clinical and laboratory clues of maturity‐onset diabetes of the young and determination of association with molecular diagnosis

Prevalence and characteristics of celiac disease in South African patients with type 1 diabetes mellitus: Results from the Durban Diabetes and Celiac Disease Study

Prevalence of gluten-related disorders in Asia-Pacific region: a systematic review

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