Celiac disease in type 1 diabetes. Girls with early diabetes manifestation are at a greater risk

Patients and Results. To determine the prevalence of celiac disease in patients with type I diabetes and investigate the clinical symptoms, we screened 183 patients with type 1 diabetes for gliadin antibodies (IgA and IgG) and IgA endomysium antibodies. In 14 (7.7%), high antibody titers were found and histology confirmed celiac disease in small-bowel biopsies. Classic symptoms were present in 2. These 14 patients (11 girls, 3 boys) were 4.3 years (mean; 1.0-10.1) old when their diabetes became manifest, 6 having been under 6. Celiac disease was diagnosed at that time or later in all but 1. Three girls also had autoimmune thyroiditis. After 1 year of gluten-free diet BMI-SD increased from 0.01 to 0.36 in 7 prepubertal children. No catch-up growth followed, and no increase in insulin dose per unit of bodyweight or change in frequency of hypoglycemic episodes. Conclusion. We find celiac disease with surprising frequency in patients with type 1 diabetes; girls with early manifestation of diabetes type 1 seem to be at high risk. Clinical symptoms can be absent, making screening essential in such patients. Longterm studies must determine the importance of gluten-free diet in silent forms of celiac disease.