Endocrine Abstracts

Background

Celiac disease (CD) occurs in patients with type1 diabetes (T1DM) ranging the prevalence of 4.4–11.1% versus 0.5% of the general population. The mechanism of association of these two diseases involves a shared genetic background.

Aim

To investigate whether in type1 diabetes (T1DM) patients the concomitance of treated celiac disease (CD) impacts glycemic control and the prevalence of microvascular complications.

Methods

This retrospective study was performed in 20 patients with type 1 diabetes mellitus and treated celiac disease (CD) admitted to section C of National Nutrition Institute from 2017 to 2020. Age at CD diagnosis, gender, type 1 diabetes duration, glucose control (HbA1c) and insulin requirement before and after diagnosis of CD, status of microvascular complications and concomitant autoimmune diseases were evaluated. The control group consisted of 20 patients with T1DM and negative CD serology matched for age, gender, T1DM duration.

Results

Of the study population, 70% were females and 30% had concomitant autoimmune diseases (hypothyroidism). Mean age and mean duration of diabetes at CD diagnosis was 28 years, 9.5 years respectively. HbA1c levels at the moment of CD diagnosis were 10% and at the most recent visit 10.22% indicating no difference. A gluten free diet had little effect on insulin dosage (from 0.8 UI/Kg per day to 0.9 UI/Kg per day). Prevalence of diabetic retinopathy was higher in T1DM+CD group compared with controls (30% vs 10%, P<0.05) whereas no difference in the prevalence of diabetic nephropathy (10%) and diabetic peripheral neuropathy (5%) was found between the two groups.

Conclusion

The co-occurrence of T1DM + CD has no impact on glycemic control. However patients with T1DM + CD have higher prevalence of diabetic retinopathy than those with T1DM alone.