Clinical Benefit of a Gluten-Free Diet in Type 1 Diabetic Children With Screening-Detected Celiac Disease: A population-based screening study with 2 years’ follow-up

OBJECTIVE —This study was performed to 1 ) determine the prevalence of celiac disease in Danish children with type 1 diabetes and 2 ) estimate the clinical effects of a gluten-free diet (GFD) in patients with diabetes and celiac disease. RESEARCH DESIGN AND METHODS —In a region comprising 24% of the Danish population, all patients RESULTS —In 28 of 33 patients with celiac antibodies, an intestinal biopsy showed villous atrophy. In 5 patients, celiac disease had been diagnosed previously, giving an overall prevalence of 12.3% (95% CI 8.6–16.9). Patients with celiac disease had a lower SD score (SDS) for height ( P P = 0.002) than patients without celiac disease and were significantly younger at diabetes onset ( P = 0.041). A GFD was obtained in 31 of 33 patients. After 2 years of follow-up, there was an increase in weight SDS ( P = 0.006) and in children P = 0.036). An increase in hemoglobin ( P = 0.002) and serum ferritin ( P = 0.020) was found, whereas HbA 1c remained unchanged ( P = 0.311) during follow-up. CONCLUSIONS —This population-based study showed the highest reported prevalence of celiac disease in type 1 diabetes in Europe. Patients with celiac disease showed clinical improvements with a GFD. We recommend screening for celiac disease in all children with type 1 diabetes.