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

Authors :
Mahmud, Farid H.
Clarke, Antoine B.M.
Joachim, Kariym C.
Assor, Esther
McDonald, Charlotte
Saibil, Fred
Lochnan, Heather A.
Punthakee, Zubin
Parikh, Amish
Advani, Andrew
Shah, Baiju R.
Perkins, Bruce A.
Zuijdwijk, Caroline S.
Mack, David R.
Koltin, Dror
De Melo, Emilia N.
Hsieh, Eugene
Mukerji, Geetha
Gilbert, Jeremy
Bax, Kevin
Source :
Diabetes Care; Jul2020, Vol. 43 Issue 7, p1553-1556, 4p
Publication Year :
2020

Abstract

<bold>Objective: </bold>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.<bold>Research Design and Methods: </bold>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 HbA1c and continuous glucose monitoring over 12 months.<bold>Results: </bold>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.<bold>Conclusions: </bold>CD is frequently observed in asymptomatic patients with type 1 diabetes, and clinical vigilance is warranted with initiation of a GFD. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01495992
Volume :
43
Issue :
7
Database :
Complementary Index
Journal :
Diabetes Care
Publication Type :
Academic Journal
Accession number :
143848842
Full Text :
https://doi.org/10.2337/dc19-1944