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Published on: July 5, 2022
Symptomless celiac disease in type 1 diabetes: 12-year experience in Estonia
Oivi Uibo1, Kaire Heilman, Tiina Rägo
1Department of Pediatrics, University of Tartu, Lunini 6, Tartu, 51014, Estonia. oivi.uibo@kliinikum.ee
Background:
We aimed to determine the prevalence and characteristics of celiac disease in children with type 1 diabetes in Estonia, a country with a formerly low frequency of both diseases.
Methods:
Altogether, 271 patients with diabetes were studied over 12 years (1995-2006): 122 at diagnosis and 149 patients 0.1-14.8 years after diagnosis. In addition, 73 patients were followed up over 1-6 years. Immunoglobulin A type endomysium and tissue transglutaminase antibodies were determined. Patients with antibodies and/or with celiac-disease-related symptoms were invited for a small-intestinal biopsy.
Results:
At the primary screening, celiac disease was histologically confirmed in nine patients (all without symptoms), that is, in 3.3% (95% confidence interval: 1.63-6.42) of type 1 diabetes cases. At follow up, celiac disease was additionally detected in two (2.7%) of 73 diabetic patients, that is, in 0.016 (95% confidence interval: 0-0.072) celiac disease cases per follow-up year.
Conclusion:
The prevalence of celiac disease among type 1 diabetes patients in Estonia is similar to that in countries with a high incidence of celiac disease and type 1 diabetes. As celiac disease is mostly symptomless, all children with type 1 diabetes, irrespective of their geographic origin, should be regularly screened for celiac disease.
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