Health Professional Attitudes Regarding Celiac Disease Screening and Treatment in Pediatric Type 1 Diabetes

OBJECTIVE: To evaluate current practices and opinions related to celiac disease screening in multidisciplinary type 1 diabetes care teams from the Network of Ontario Pediatric Diabetes Programs. METHODS: A multi-item survey specific to celiac disease and type 1 diabetes was distributed to members of this provincial organization. RESULTS: In total, 54 surveys were completed. Overall, 75% of respondents felt universal celiac disease screening of patients with type 1 diabetes should occur, and 67% reported actively screening at their centre. A majority reported recommending a gluten-free diet to all patients with celiac disease, but a third were uncertain whether this was appropriate for asymptomatic patients. With respect to long-term complications, 49% of respondents felt asymptomatic and symptomatic patients were at equal risk, while 43% were unsure. Patients' dietary adherence was reported as excellent. CONCLUSION: Despite the fact that the 2008 Canadian Diabetes Association guidelines do not recommend universal screening for celiac disease, and notwithstanding ambiguity about treatment impact in asymptomatic patients, many Ontario pediatric centres are screening patients with type 1 diabetes.