1. Screening and Treatment Outcomes in Adults and Children With Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study.
- Author
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Mahmud FH, Clarke ABM, Joachim KC, Assor E, McDonald C, Saibil F, Lochnan HA, Punthakee Z, Parikh A, Advani A, Shah BR, Perkins BA, Zuijdwijk CS, Mack DR, Koltin D, De Melo EN, Hsieh E, Mukerji G, Gilbert J, Bax K, Lawson ML, Cino M, Beaton MD, Saloojee NA, Lou O, Gallego PH, Bercik P, Houlden RL, Aronson R, Kirsch SE, Paterson WG, and Marcon MA
- Subjects
- Adolescent, Adult, Asymptomatic Diseases, Autoantibodies analysis, Autoantibodies blood, Biopsy, Blood Glucose analysis, Blood Glucose metabolism, Blood Glucose Self-Monitoring, Canada, Celiac Disease blood, Celiac Disease complications, Child, Diabetes Mellitus, Type 1 blood, Diabetes Mellitus, Type 1 complications, Diabetes Mellitus, Type 1 diagnosis, Female, Humans, Male, Mass Screening, Middle Aged, Postprandial Period, Serologic Tests, Treatment Outcome, Young Adult, Celiac Disease diagnosis, Celiac Disease diet therapy, Diabetes Mellitus, Type 1 diet therapy, Diet, Gluten-Free
- Abstract
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 HbA1c 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., (© 2020 by the American Diabetes Association.)- Published
- 2020
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