Affiliation:
1. University Department of Paediatrics, Addenbrooke’s Hospital, Cambridge, U.K.
2. Department of Paediatrics, John Radcliffe Hospital, Oxford, U.K.
Abstract
OBJECTIVE—To describe the longitudinal growth characteristics and glycemic control in type 1 diabetic children diagnosed with celiac disease and started on a gluten-free diet (GFD).
RESEARCH DESIGN AND METHODS—Data on growth and glycemic control for 11 case subjects diagnosed with celiac disease (cd+ group) and started on a GFD were collected prospectively, and two control subjects without celiac disease matched for age, sex, and duration of diabetes (cd− group) were selected for comparison.
RESULTS—In the period between diagnosis of type 1 diabetes and start of a GFD in the cd+ compared with the cd− group, BMI standard deviation score (SDS) was lower (–0.2 vs. 0.7, P = 0.015), as was HbA1c (8.9 vs. 9.8%, P = 0.002). In a regression model the cd+ group had lower BMI SDS (P < 0.001) and lower HbA1c (P = 0.04), independent of other variables. On a GFD, BMI SDS increased by 12 months in the cd+ group and then was no different than the cd− group (1.1 vs. 1.0, P = 0.11), whereas HbA1c improved further within case subjects compared with pre-GFD (8.9 vs. 8.3%, P = 0.002). On a GFD, case subjects in contrast to control subjects showed no deterioration in HbA1c during the years of puberty (8.3 vs. 10.0%, P = 0.022)
CONCLUSIONS—In children with type 1 diabetes, untreated celiac disease resulted in lower BMI SDS and lower HbA1c. Recovery of BMI SDS with a GFD was associated with further improvement in HbA1c as compared with pre-GFD, with no expected deterioration in glycemic control during puberty. These apparent clinical benefits need confirming by larger studies.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
99 articles.
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