Examining the Prevalence of Celiac Disease in Patients with Type 1 Diabetes Mellitus

Laurel Wood, MD

Investigators, including Laurel Wood, MD, University of Chicago, found that patients with type 1 diabetes mellitus (T1DM) are at an increased risk of developing celiac disease. Compared with the general population, the prevalence of celiac disease in people with type 1 diabetes is 5-7 times higher.

For this study, an IRB-approved chart review was conducted on patients under 21 years old who received treatment from University of Chicago and were diagnosed with both T1DM and celiac disease. Patient medical charts were reviewed to account for diagnosis, pathologic results, serologic test results, and patient demographics.

The total number of patients diagnosed with T1DM and celiac disease was 63. The need for regular screening for celiac disease in children diagnosed with T1DM was shown by 7 patients who initially had negative results from their celiac screening but became positive up to 7.25 years later.

Of the total patients included, 52% were female. As for racial identity, 86% were white, 5% were Asian, 3% were black, and 6% were unknown. 5% identified as Hispanic or Latino.

Patients with T1DM were first screened for celiac disease within a median of 2.29 years after their T1DM diagnosis. The diagnoses of celiac disease included serology alone (16), duodenal biopsy (39), and other (8).

TTG and EMA showed a strong correlation, while high DGP IgA and DGP IgG were not necessarily the best indicators or damage to duodenal mucosa in patients with T1DM.

In order to better understand the utility of celiac disease antibodies in predicting severity of disease in T1DM children, further studies with larger samples of T1DM patients with Marsh scores less than 3 and increased celiac disease serology are indicated.

The study, “Threshold for Undergoing Celiac Disease Diagnosis in Pediatric Type 1 Diabetes Mellitus Patients” was presented at the American College of Gastroenterology 2021 conference.