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High prevalence of microvascular complications in adults with type 1 diabetes and newly diagnosed celiac disease.

AbstractOBJECTIVE:
The implications of celiac disease (CD) in adult patients with type 1 diabetes are unknown, with respect to diabetes-related outcomes including glycemic control, lipids, microvascular complications, quality of life, and the effect of a gluten-free diet (GFD). We identified CD in adults with type 1 diabetes and investigated the effect of a GFD on diabetes-related complications.
RESEARCH DESIGN AND METHODS:
This was a case-control study conducted at a U.K. teaching hospital. Patients with type 1 diabetes aged >16 years (n = 1,000) were assessed for CD. HbA(1c), lipid profile, quality of life, retinopathy stage, nephropathy stage, and degree of neuropathy before and after 1 year on a GFD were assessed.
RESULTS:
The prevalence of CD was 33 per 1,000 subjects (3.3% [95% CI 2.3-4.6]). At diagnosis of CD, adult type 1 diabetic patients had worse glycemic control (8.2 vs. 7.5%, P = 0.05), lower total cholesterol (4.1 vs. 4.9, P = 0.014), lower HDL cholesterol (1.1 vs. 1.6, P = 0.017), and a higher prevalence of retinopathy (58.3 vs. 25%, P = 0.02), nephropathy (41.6 vs. 4.2%, P = 0.009), and peripheral neuropathy (41.6 vs. 16.6%, P = 0.11). There was no difference in quality of life (P > 0.1). After 1 year on a GFD, only the lipid profile improved overall, but in adherent individuals HbA(1c) and markers for nephropathy improved.
CONCLUSIONS:
Adults with undetected CD and type 1 diabetes have worse glycemic control and a higher prevalence of retinopathy and nephropathy. Treatment with a GFD for 1 year is safe in adults with type 1 diabetes and does not have a negative impact on the quality of life.
AuthorsJohn S Leeds, Andrew D Hopper, Marios Hadjivassiliou, Solomon Tesfaye, David S Sanders
JournalDiabetes care (Diabetes Care) Vol. 34 Issue 10 Pg. 2158-63 (Oct 2011) ISSN: 1935-5548 [Electronic] United States
PMID21911773 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Blood Glucose
Topics
  • Adolescent
  • Adult
  • Blood Glucose (metabolism)
  • Case-Control Studies
  • Celiac Disease (blood, complications, diet therapy)
  • Diabetes Mellitus, Type 1 (blood, complications, diet therapy)
  • Diabetic Nephropathies (blood, diet therapy, etiology)
  • Diabetic Retinopathy (blood, diet therapy, etiology)
  • Diet, Gluten-Free
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Young Adult

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