Anthropometry, Metabolic Control, and Follow-Up in Children and Adolescents with Type 1 Diabetes Mellitus and Biopsy-Proven Celiac Disease

• Published in: The Journal of pediatrics Vol. 158; no. 4; pp. 589 - 593.e2
• Main Authors: Fröhlich-Reiterer, Elke E., MD, Kaspers, Stefan, MD, Hofer, Sabine, MD, PhD, Schober, Edith, MD, PhD, Kordonouri, Olga, MD, PhD, Pozza, Susanne Bechtold-Dalla, MD, PhD, Holl, Reinhard W., MD, PhD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 01.04.2011; Elsevier
• Subjects: Adolescent; adolescents; anthropometric measurements; Biological and medical sciences; celiac disease; Celiac Disease - epidemiology; Celiac Disease - immunology; Child; Child, Preschool; children; Comorbidity; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 1 - metabolism; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; glycohemoglobin; Humans; hypoglycemia; Infant; insulin-dependent diabetes mellitus; Male; males; Medical sciences; Other diseases. Semiology; patients; Pediatrics; screening; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; surveys; Austria; Germany; T1DM; CD; Endomysium antibodies; SDS; GFD; Standard deviation score; Biopsy-proven celiac disease; tTga; Transglutaminase antibodies; BPCD; Body mass index; Celiac disease; Hemoglobin A1c; EMA; Gluten-free diet; HbA1c; BMI; Type 1 diabetes mellitus; Endocrinopathy; Human; Immunopathology; Pediatrics; Anthropometry; Check; Autoimmune disease; Coeliac disease; Metabolism; Anatomic pathology; Surveillance; Intestinal malabsorption; Biopsy; Type 1 diabetes; Follow up study; Adolescent; Digestive diseases; Intestinal disease; Child
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2010.09.050

Objective To evaluate the influence of biopsy-proven celiac disease (BPCD) on somatic development and metabolic parameters in children with type 1 diabetes mellitus (T1DM) in a multicenter survey. Study design Within the Diabetes Patienten Verlaufsdokumentationssystem–Wiss project, data of 41 951 patients with T1DM, aged <20 years (52% males, mean age 13.9 years; mean duration of diabetes 5.5 years) were collected in 297 centers in Germany and Austria from 1995 to 2009. Results The number of BPCD (0.6% in 1995; 1.3% in 2008) has increased over time. Patients with BPCD were significantly younger at diabetes onset (5.9 vs 8.3 years), had a significantly lower weight standard deviation score (SDS); (0.20 vs 0.43) and height SDS (-0.28 vs -0.03) ( P < .001, each) compared with patients without celiac disease. No differences were found in hemoglobin A1c or numbers of severe hypoglycemia. In a subgroup of 9805 patients (183 with BPCD) significantly lower height and weight SDS ( P < .001) were still found after a 5-year follow-up. Conclusions Screening for celiac disease is important in children with T1DM to prevent persistent growth failure.