Screening and Treatment Outcomes in Adults and Children With Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study

被引：27

作者：

Mahmud, Farid H. ^{[1
]}

Clarke, Antoine B. M. ^{[1
]}

Joachim, Kariym C. ^{[1
]}

Assor, Esther ^{[1
]}

McDonald, Charlotte ^{[2
]}

Saibil, Fred ^{[3
]}

Lochnan, Heather A. ^{[4
]}

Punthakee, Zubin ^{[5
]}

Parikh, Amish ^{[6
]}

Advani, Andrew ^{[7
]}

Shah, Baiju R. ^{[8
]}

Perkins, Bruce A. ^{[9
]}

Zuijdwijk, Caroline S. ^{[10
]}

Mack, David R. ^{[11
]}

Koltin, Dror ^{[6
]}

De Melo, Emilia N. ^{[1
]}

Hsieh, Eugene ^{[12
]}

Mukerji, Geetha ^{[13
]}

Gilbert, Jeremy ^{[8
]}

Bax, Kevin ^{[14
]}

Lawson, Margaret L. ^{[10
]}

Cino, Maria ^{[15
]}

Beaton, Melanie D. ^{[16
]}

Saloojee, Navaaz A. ^{[17
]}

Lou, Olivia ^{[18
]}

Gallego, Patricia H. ^{[19
]}

Bercik, Premysl ^{[20
]}

Houlden, Robyn L. ^{[21
]}

Aronson, Ronnie ^{[22
]}

Kirsch, Susan E. ^{[23
]}

Paterson, William G. ^{[24
]}

Marcon, Margaret A. ^{[25
]}

机构：

[1] Univ Toronto, Hosp Sick Children, Dept Pediat, Div Endocrinol, Toronto, ON, Canada

[2] Western Univ, Div Endocrinol & Metab, St Josephs Hlth Care, London Hlth Sci Ctr, London, ON, Canada

[3] Univ Toronto, Sunnybrook Hlth Sci Ctr, Div Gastroenterol, Toronto, ON, Canada

[4] Ottawa Hosp, Dept Endocrinol, Ottawa, ON, Canada

[5] McMaster Univ, Dept Med, Hamilton, ON, Canada

[6] Trillium Hlth Partners, Div Endocrinol, Toronto, ON, Canada

[7] St Michaels Hosp, Div Endocrinol, Toronto, ON, Canada

[8] Sunnybrook Hlth Sci Ctr, Div Endocrinol & Metab, Toronto, ON, Canada

[9] Univ Toronto, Univ Hlth Network, Div Endocrinol & Metab, Toronto, ON, Canada

[10] Univ Ottawa, Childrens Hosp Eastern Ontario, Div Endocrinol & Metab, Ottawa, ON, Canada

[11] Univ Ottawa, Childrens Hosp Eastern Ontario, Div Gastroenterol Hepatol & Nutr, Ottawa, ON, Canada

[12] Sunnybrook Hlth Sci Ctr, Dept Pathol, Toronto, ON, Canada

[13] Womens Coll Hosp, Div Endocrinol, Toronto, ON, Canada

[14] Western Univ, London Hlth Sci Ctr, Dept Pediat, Pediat Gastroenterol, London, ON, Canada

[15] Univ Toronto, Univ Hlth Network, Div Gastroenterol, Toronto, ON, Canada

[16] London Hlth Sci Ctr, Div Gastroenterol, London, ON, Canada

[17] Ottawa Hosp, Dept Gastroenterol, Ottawa, ON, Canada

[18] JDRF, New York, NY USA

[19] Western Univ, Div Endocrinol, Childrens Hosp, London Hlth Sci Ctr, London, ON, Canada

[20] McMaster Univ, Dept Gastroenterol, Hamilton, ON, Canada

[21] Kingston Gen Hosp, Dept Endocrinol, Kingston, ON, Canada

[22] LMC Diabet & Endocrinol, Toronto, ON, Canada

[23] Markham Stouffville Hosp, Div Endocrinol, Markham, ON, Canada

[24] Kingston Gen Hosp, Dept Gastroenterol, Kingston, ON, Canada

[25] Univ Toronto, Hosp Sick Children, Dept Pediat, Div Gastroenterol Hepatol & Nutr, Toronto, ON, Canada

来源：

DIABETES CARE | 2020年 / 43卷 / 07期

关键词：

RISK;

D O I：

10.2337/dc19-1944

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE To describe celiac disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in patients with type 1 diabetes who are asymptomatic for CD. RESEARCH DESIGN AND METHODS Asymptomatic patients (8-45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA(1c)and continuous glucose monitoring over 12 months. RESULTS Adults had higher CD-seropositivity rates than children (6.8% [95% CI 4.9-8.2%,N= 1,298] vs. 4.7% [95% CI 3.4-5.9%,N= 1,089],P= 0.035) with lower rates of prior CD screening (6.9% vs. 44.2%,P< 0.0001). Fifty-one participants were randomized to a GFD (N= 27) or GCD (N= 24). No HbA(1c)differences were seen between the groups (+0.14%, 1.5 mmol/mol; 95% CI -0.79 to 1.08;P= 0.76), although greater postprandial glucose increases (4-h +1.5 mmol/L; 95% CI 0.4-2.7;P= 0.014) emerged with a GFD. CONCLUSIONS CD is frequently observed in asymptomatic patients with type 1 diabetes, and clinical vigilance is warranted with initiation of a GFD.

引用

页码：1553 / 1556

页数：4

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