All Children With Type 1 Diabetes Should Be Tested for Celiac Disease: Children With Both Diseases Should Eat a Diet Without Gluten

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Clinical benefit of a gluten-free diet in type 1 diabetic children with screening-detected celiac disease: a population-based screening study with 2 years’ follow-up, by D. Hansen and colleagues. Diabetes Care 29:2452-2456, 2006.

What is the problem and what is known about it so far?

In some people, a type of food called gluten (found in all forms of wheat and many other grains) hurts the intestines, a part of the body that helps digest food. This is called celiac disease. Celiac disease happens more often with type 1 diabetic children than with the general population. Many people wonder if all type 1 diabetic children should be tested often for celiac disease.

The ability of a diet without gluten (“gluten-free diet” or GFD) to control symptoms of the two diseases has been tested, but the tests have not given scientists any clear answers.

Why did the researchers do this particular study?

This study was done to determine how many type 1 diabetic children in Denmark also have celiac disease. The researchers also wanted to see if a GFD makes symptoms go away when children have both diseases.

How was the study done?

The researchers chose a place in Denmark where almost one-quarter of the country's people lived. They then used local health records to find all people younger than 16 years old who had type 1 diabetes. Out of these young people, 89% were studied.

The children were asked questions about their symptoms, and then many tests were used to figure out which diabetic children also had celiac disease. The children with both diseases were told to eat a GFD, and then doctors tested them often for the next 2 years to see how they were doing.

What did the researchers find?

When researchers tested children with type 1 diabetes, they found that 12.3% also had celiac disease. This is a much bigger number than other scientists found in nearby countries.

Diabetic children with celiac disease were mostly children who were diagnosed with diabetes at a much younger age than the diabetic children who didn’t have celiac disease.

Most diabetic children with celiac disease noticed symptoms, but many did not. Children who had both diseases had more stunted growth in terms of height and weight. Symptoms of celiac disease went away in children who ate a GFD for 2 years. Growth problems got better too, especially for children younger than 14 years old.

What are the limitations to the study?

The testing might not have found all cases of celiac disease, but the tests were better than the ones that other scientists used when they studied nearby countries. Also, the researchers tested a larger part of the country’s total number of people. This means that more type 1 diabetic children in other countries might also have celiac disease.

What are the implications of the study?

More type 1 diabetic children may have celiac disease than people thought. Because many do not show symptoms, children with type 1 diabetes should be tested often for celiac disease.

There is a very good chance that if a child with both diseases goes on a GFD early in life, then the GFD will make symptoms go away. A GFD also will also lessen the chance that a child with both diseases will have stunted growth.

FOR MORE INFORMATION

Celiac Disease

Diabetes and Celiac Disease: Nutrition

Ten Keys to Helping Your Child Grow Up With Diabetes, 2nd Edition