Children With Celiac Disease Are at a Higher Risk for Type 1 Diabetes and Death From Diabetes

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Celiac disease and risk of subsequent type 1 diabetes: a general population cohort study of children and adolescents, by J.F. Ludvigsson and colleagues. Diabetes Care 29:2483-2488, 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. In the past, researchers found that people with type 1 diabetes get celiac disease more often than the general population. On the other hand, there has not been much research to see if people with celiac disease get type 1 diabetes more often than the general population.

Why did the researchers do this particular study?

This study was done to see if people with celiac disease get type 1 diabetes more often than people who don’t have celiac disease. The researchers also wanted to see if people who get celiac disease first then get type 1 diabetes that is harder to control than usual.  When type 1 diabetes is harder to control, there is more risk of dying from diabetes.

Because a diet without gluten can help the symptoms of celiac disease go away, the researchers thought that people with celiac disease who ate food without gluten for a long time might get type 1 diabetes less often than people who ate more gluten in their lives. For this reason, the researchers tested to see if people whose celiac disease is found early in childhood get type 1 diabetes less often than people whose celiac disease is found later in life. 

How was the study done?

The researchers searched records from hospitals in Sweden to find people who had celiac disease. The researchers then used other public records to come up with another group of people who did not have celiac disease. The researchers made sure that the two groups were very alike in many ways, so that the biggest difference between them was whether or not they had celiac disease. People with celiac disease were not included if they already had diabetes when doctors first found the celiac disease.

The health history of the people in both groups was studied and compared to each other. The researchers only studied the health history of the first twenty years of people’s lives.

What did the researchers find?

Children with celiac disease had a much higher risk of getting type 1 diabetes compared with children who did not have celiac disease. Children who had celiac disease before type 1 diabetes also had a higher risk of dying from diabetes before age twenty. The age at which celiac disease was found did not affect whether children got type 1 diabetes afterwards.

What are the limitations to the study?

Only girls with celiac disease and type 1 diabetes had a higher risk of dying from diabetes; boys did not.

Other studies show that children who are fed gluten at a very early age have a very high risk of getting celiac disease and/or diabetes. This means that celiac disease might not be causing children to get diabetes. The gluten might cause both diseases to happen. In that case, the question of which disease came first is not as important.

What are the implications of the study?

Children with celiac disease will often get type 1 diabetes afterwards. Finding celiac disease early in childhood does not protect children from getting type 1 diabetes. This means that a gluten-free diet that is started after celiac disease is found does not appear to prevent type 1 diabetes.

FOR MORE INFORMATION

Celiac Disease

Diabetes and Celiac Disease: Nutrition

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