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Looking for coeliac disease in children with type 1 diabetes mellitus

Jody A Porter1, Karen MacKenzie, Brian Darlow

  • 1Paediatric Department, University of Otago, Christchurch, New Zealand.

Journal of Paediatrics and Child Health
|July 22, 2014
PubMed

Insights

Most New Zealand clinicians screen children with type 1 diabetes mellitus (T1DM) for coeliac disease (CD). However, practices vary, with some clinicians relying on symptoms rather than routine screening protocols.

Area of Science:

  • Pediatric Endocrinology
  • Gastroenterology
  • Autoimmune Diseases

Background:

  • Type 1 diabetes mellitus (T1DM) is associated with an increased risk of coeliac disease (CD).
  • Early screening and management of CD in T1DM can prevent long-term complications.

Purpose of the Study:

  • To investigate the current practices of New Zealand (NZ) clinicians regarding the screening and management of CD in pediatric patients with T1DM.
  • To identify variations in diagnostic and therapeutic approaches.

Main Methods:

  • An online survey was distributed to all clinicians managing children under 15 years with T1DM in NZ in 2010.
  • The survey collected data on personal and departmental protocols for CD screening and management in T1DM patients.

Main Results:

  • 34 out of 37 clinicians responded, indicating a high response rate.
  • Most clinicians have a protocol for CD screening in T1DM, with 25/34 screening at diagnosis.
  • Anti-tissue transglutaminase antibody testing is universally used for screening, and biopsy confirmation is standard for initiating a gluten-free diet (GFD).

Conclusions:

  • The majority of NZ clinicians screen for CD in pediatric T1DM patients.
  • Significant variations exist in the specific screening and management approaches employed by clinicians.
Abstract

Keywords:
coeliac diseasediabetes mellitusgrowth and developmentpaediatricsscreeningtype 1

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