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Glycaemic Control and Body Mass Index in Children with Type 1 Diabetes with and without Celiac Disease: A
Hanna Söderström1,2, Marie Lindgren1,3, Helena Elding Larsson4,5
1Department of Clinical Sciences, Lund University, Lund, Sweden.
Insights
Children with type 1 diabetes (T1D) and celiac disease (CD) have lower BMI-SDS, especially when diagnosed concurrently. CD diagnosis timing does not affect glycaemic control in T1D patients.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Metabolic Disorders
Background:
- Type 1 diabetes (T1D) carries a high risk for celiac disease (CD) in children.
- Previous research on CD's impact on growth and glycemic control in T1D yielded inconsistent results.
- The timing of CD diagnosis relative to T1D onset has not been previously studied.
Purpose of the Study:
- To investigate the influence of CD on body mass index (BMI) and glycemic control in children with T1D.
- To determine if the timing of CD diagnosis (before, with, or after T1D) impacts these outcomes.
Main Methods:
- A cohort of 3612 Swedish children diagnosed with T1D between 2005-2010 were included.
- Participants were screened for CD at T1D diagnosis and annually for five years.
- Assessed outcomes included BMI-SDS, HbA1c, and DKA at diagnosis and during follow-up.
Main Results:
- Children diagnosed with CD concurrently with T1D showed significantly lower BMI-SDS throughout follow-up.
- Those diagnosed with CD before T1D also had lower BMI-SDS during the initial two years.
- No association was found between CD status and HbA1c or DKA.
Conclusions:
- Children with T1D and CD diagnosed simultaneously or with pre-existing CD exhibit reduced BMI-SDS for up to five years post-T1D diagnosis.
- These children may benefit from enhanced nutritional support.
- The presence or timing of CD diagnosis does not appear to affect glycemic control in children with T1D.
Introduction:
The risk of celiac disease (CD) is high in children with type 1 diabetes (T1D). While some studies have linked CD in children with T1D to impaired growth and poorer glycaemic control, results have been inconsistent. Further, no study has examined the relevance of whether the diagnosis of CD is established before, in conjunction with, or after T1D. We aimed to examine whether CD influences body mass index (BMI) and glycaemic control in children with T1D, and whether the timing of the onset of CD is of relevance.
Methods:
Swedish children diagnosed with T1D between 2005 and 2010 who were enrolled in the Better Diabetes Diagnosis study (N = 3,612; >90% national coverage) were included. The participants were screened for CD at T1D diagnosis and annually for 5 years. BMI-standard deviation score (BMI-SDS), glycaemic control (HbA1c), and diabetes ketoacidosis (DKA) were assessed at T1D diagnosis, BMI-SDS, and HbA1c at five annual follow-ups.
Results:
Children diagnosed with CD at the same time as the T1D diagnosis had statistically significantly lower BMI-SDS compared to children without a CD diagnosis at all follow-up assessments. Children diagnosed with CD before T1D had a significantly lower BMI-SDS during the first 2 years of follow-up. CD status was not associated with HbA1c or DKA at T1D diagnosis or during follow-up.
Conclusion:
Children diagnosed with T1D with known or identified CD at the time of diagnosis had a lower BMI-SDS up to 5 years after T1D diagnosis and may require additional nutritional support. The presence or timing of a CD diagnosis does not appear to be associated with glycaemic control in children with T1D.
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