echemi logo
Product
  • Product
  • Supplier
  • Inquiry
    Home > Active Ingredient News > Endocrine System > Diabetologia: Early and late histological confirmation of celiac disease in children with new-onset type 1 diabetes

    Diabetologia: Early and late histological confirmation of celiac disease in children with new-onset type 1 diabetes

    • Last Update: 2022-05-19
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com

    Background: Celiac disease is a common complication of type 1 diabetes in children and adolescents
    .
    Many people are asymptomatic at diagnosis, identified by screening for IgA antibodies against tissue transglutaminase (anti-tTGA)

    .
    There is currently no clear evidence whether asymptomatic patients with type 1 diabetes benefit from a gluten-free diet (GFD)]

    .
    However, some studies have shown that asymptomatic celiac disease negatively affects growth and weight gain in children, although no effect on blood sugar control has been shown
    .
    It has also been shown that in a substantial proportion of children with type 1 diabetes, mildly elevated serum anti-TGA levels at the onset of diabetes decrease or even become negative over time despite continued gluten intake
    .

    Background: Celiac disease is a common complication of type 1 diabetes in children and adolescents
    .
    Many people are asymptomatic at diagnosis, identified by screening for IgA antibodies against tissue transglutaminase (anti-tTGA)

    .
    There is currently no clear evidence whether asymptomatic patients with type 1 diabetes benefit from a gluten-free diet (GFD)]

    .
    However, some studies have shown that asymptomatic celiac disease negatively affects growth and weight gain in children, although no effect on blood sugar control has been shown
    .
    It has also been shown that in a substantial proportion of children with type 1 diabetes, mildly elevated serum anti-TGA levels at the onset of diabetes decrease or even become negative over time despite continued gluten intake
    .
    Celiac disease is a common complication of type 1 diabetes in children and adolescents
    .
    Many people are asymptomatic at diagnosis, identified by screening for IgA antibodies against tissue transglutaminase (anti-tTGA)

    .
    There is currently no clear evidence whether asymptomatic patients with type 1 diabetes benefit from a gluten-free diet (GFD)]

    .
    It has also been shown that in a substantial proportion of children with type 1 diabetes, mildly elevated serum anti-TGA levels at the onset of diabetes decrease or even become negative over time despite continued gluten intake
    .

    OBJECTIVE: The aim of this study was to analyze whether children and adolescents with new-onset type 1 diabetes and a positive screening result could delay the diagnosis of celiac disease
    .
    We compared metabolic outcomes, cardiovascular risk factors, acute complication rates, GFD adherence, weight gain and growth in children and adolescents with new-onset type 1 diabetes and elevated anti-tTGA levels at the onset of diabetes who received Histological confirmation of early or advanced celiac disease

    .

    OBJECTIVE: The aim of this study was to analyze whether children and adolescents with new-onset type 1 diabetes and a positive screening result could delay the diagnosis of celiac disease
    .
    We compared metabolic outcomes, cardiovascular risk factors, acute complication rates, GFD adherence, weight gain and growth in children and adolescents with new-onset type 1 diabetes and elevated anti-tTGA levels at the onset of diabetes who received Histological confirmation of early or advanced celiac disease

    .

    METHODS: This was a multicenter population cohort study
    .
    Participants ≤18 years of age who were diagnosed with type 1 diabetes between 1995 and June 2021 and had elevated IgA tissue transglutaminase antibodies (anti-tTGA) on celiac disease screening at diabetes onset were included

    .
    We compared the outcomes of participants with diabetes lasting more than 1 year who had histologically confirmed celiac disease within the first 6 months and celiac disease diagnosed within 6 to 36 months after diabetes diagnosis

    .

    METHODS: This was a multicenter population cohort study
    .
    Participants ≤18 years of age who were diagnosed with type 1 diabetes between 1995 and June 2021 and had elevated IgA tissue transglutaminase antibodies (anti-tTGA) on celiac disease screening at diabetes onset were included

    .
    We compared the outcomes of participants with diabetes lasting more than 1 year who had histologically confirmed celiac disease within the first 6 months and celiac disease diagnosed within 6 to 36 months after diabetes diagnosis

    .

    RESULTS: Among 92,278 children and adolescents diagnosed with type 1 diabetes, 26,952 (29.
    2%) had anti-tTGA data records at the time of diabetes onset

    .
    Of these, 2340 (8.
    7%) had elevated anti-tTGA levels

    .
    Screen-positive individuals were younger (median age 9.
    0 vs 9.
    8 years, p<0.
    001) and more common in women (53.
    1% vs 44.
    4%, p<0.
    001)

    .
    A total of 533 participants (22.
    8% of those who screened positive) had documented biopsies, of which 444 had documented histological confirmation of celiac disease

    .
    Of the 411 participants with biopsy-proven celiac disease and follow-up data in the 36 months prior to diabetes, 264 (64.
    2%) were in the first 6 months after diabetes onset and 147 (35.
    8%) were Histological confirmation was performed 6 to 36 months later

    .
    At follow-up (median diabetes duration 5.
    3 and 5.
    1 years, respectively), estimated median HbA1c levels (62.
    8 mmol/mol vs 62.
    2 mmol/mol [7.
    9% vs 7.
    8%]), cardiovascular risk markers (blood lipids , microalbuminuria, blood pressure), the incidence of acute diabetic complications (diabetic ketoacidosis, severe hypoglycemia), and the proportion of participants achieving anti-tTGA levels within the normal range did not differ between groups

    .
    During the observation period, participants with delayed histological diagnosis of celiac disease showed no negative effects on growth or weight gain

    .

    RESULTS: Among 92,278 children and adolescents diagnosed with type 1 diabetes, 26,952 (29.
    2%) had anti-tTGA data records at the time of diabetes onset

    .
    Of these, 2340 (8.
    7%) had elevated anti-tTGA levels

    .
    Screen-positive individuals were younger (median age 9.
    0 vs 9.
    8 years, p<0.
    001) and more common in women (53.
    1% vs 44.
    4%, p<0.
    001)

    .
    A total of 533 participants (22.
    8% of those who screened positive) had documented biopsies, of which 444 had documented histological confirmation of celiac disease

    .
    Of the 411 participants with biopsy-proven celiac disease and follow-up data in the 36 months prior to diabetes, 264 (64.
    2%) were in the first 6 months after diabetes onset and 147 (35.
    8%) were Histological confirmation was performed 6 to 36 months later

    .
    At follow-up (median diabetes duration 5.
    3 and 5.
    1 years, respectively), estimated median HbA1c levels (62.
    8 mmol/mol vs 62.
    2 mmol/mol [7.
    9% vs 7.
    8%]), cardiovascular risk markers (blood lipids , microalbuminuria, blood pressure), the incidence of acute diabetic complications (diabetic ketoacidosis, severe hypoglycemia), and the proportion of participants achieving anti-tTGA levels within the normal range did not differ between groups

    .
    During the observation period, participants with delayed histological diagnosis of celiac disease showed no negative effects on growth or weight gain

    .

    Figure 1 (a) Proportion of children and adolescents with new-onset type 1 diabetes who received tTGA antibody screening at the onset of type 1 diabetes and (b) histology for celiac disease following a positive screening result since 2001
    .
    Error bars indicate 95% agreement

    Figure 1 (a) Proportion of children and adolescents with new-onset type 1 diabetes who received tTGA antibody screening at the onset of type 1 diabetes and (b) histology for celiac disease following a positive screening result since 2001
    .
    Error bars indicate 95% agreement

    Table 1 Adjusted outcome variables for participants with early versus delayed histological diagnosis of celiac disease (n = 411) at the last follow-up visit

    Table 1 Adjusted outcome variables for participants with early versus delayed histological diagnosis of celiac disease (n = 411) at the last follow-up visit

    Figure 2 SDS values ​​of (a) height and (b) body mass index in patients with early versus delayed biopsy-proven celiac disease
    .
    Error bars represent 95% agreement

    .
    SDS values ​​were shown at diagnosis of type 1 diabetes (409 for both), at biopsy (279 and 277, respectively), 2 years after biopsy (365 for both) and at last follow-up (409 for both; Median diabetes duration in the early and delayed biopsy groups was 5.
    3 and 5.
    1 years, respectively)

    Figure 2 SDS values ​​of (a) height and (b) body mass index in patients with early versus delayed biopsy-proven celiac disease
    .
    Error bars represent 95% agreement

    .
    SDS values ​​were shown at diagnosis of type 1 diabetes (409 for both), at biopsy (279 and 277, respectively), 2 years after biopsy (365 for both) and at last follow-up (409 for both; Median diabetes duration in the early and delayed biopsy groups was 5.
    3 and 5.
    1 years, respectively)

    Table 2 assesses acute complications of diabetes in patients with early versus delayed histologically diagnosed celiac disease (n = 411)

    Table 2 assesses acute complications of diabetes in patients with early versus delayed histologically diagnosed celiac disease (n = 411)

    Conclusions: Our study suggests that in asymptomatic patients with new-onset type 1 diabetes, the histological diagnosis of celiac disease may be delayed
    .

    Conclusions: Our study suggests that in asymptomatic patients with new-onset type 1 diabetes, the histological diagnosis of celiac disease may be delayed
    .
    Our study suggests that in asymptomatic patients with new-onset type 1 diabetes, the histological diagnosis of celiac disease may be delayed
    .

    Original source: Kamrath C, Tittel SR, Dunstheimer D, et al.
    Early vs late histological confirmation of coeliac disease in children with new-onset type 1 diabetes.
    Diabetologia 2022 Apr 30

    Original source: Kamrath C, Tittel SR, Dunstheimer D, et al.
    Early vs late histological confirmation of coeliac disease in children with new-onset type 1 diabetes.
    Diabetologia 2022 Apr 30
    Early vs late histological confirmation of coeliac disease in children with new- onset type 1 diabetes.


    Leave a message here
    This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent ECHEMI's opinion. If you have any queries, please write to service@echemi.com. It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to service@echemi.com with relevant evidence.