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Coeliac disease in children with type 1 diabetes: are current guidelines proving difficult to implement in practice?

Rachel Atherton1, Alexander Ross, Flora Jessop

  • 1*Department of Paediatric Gastroenterology, Hepatology and Nutrition, Addenbrooke's Hospital †Department of Histopathology ‡Department of Paediatric Endocrinology, Addenbrooke's Hospital, Cambridge, UK.

Journal of Pediatric Gastroenterology and Nutrition
|July 26, 2014
PubMed

Insights

Coeliac disease (CD) affects 5.8% of children with type 1 diabetes mellitus (T1DM). Current paediatrician practices for diagnosing CD in T1DM patients vary significantly, indicating a need for improved guideline dissemination.

Area of Science:

  • Pediatric Gastroenterology
  • Endocrinology
  • Clinical Practice Guidelines

Background:

  • Updated European guidelines (2012) provide distinct algorithms for diagnosing coeliac disease (CD) in children with type 1 diabetes mellitus (T1DM).
  • Coeliac disease is a significant comorbidity in individuals with type 1 diabetes mellitus.

Purpose of the Study:

  • To determine the period prevalence of coeliac disease in a paediatric T1DM population.
  • To assess current paediatrician practices and guideline adherence for diagnosing coeliac disease in T1DM patients 16 months post-guideline publication.

Main Methods:

  • Retrospective analysis of patient data to establish CD prevalence in T1DM.
  • A questionnaire survey distributed to paediatricians to evaluate diagnostic practices for CD in T1DM.

Main Results:

  • A period prevalence of 5.8% for coeliac disease was observed in the paediatric T1DM population at a tertiary centre.
  • Significant variation in current diagnostic practices and adherence to European guidelines among paediatricians was identified.

Conclusions:

  • Current clinical practice for diagnosing coeliac disease in paediatric patients with type 1 diabetes mellitus is inconsistent.
  • Further dissemination and potential simplification of existing European guidelines are recommended to improve diagnostic consistency.

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