Prevalence and clinical profile of celiac disease in type 1 diabetes mellitus in north India

• Published in: Journal of gastroenterology and hepatology 2011-02, Vol.26 (2), p.378-381
• Main Authors: Bhadada, Sanjay Kumar, Kochhar, Rakesh, Bhansali, Anil, Dutta, Usha, Kumar, Padala R, Poornachandra, Kuchhangi S, Vaiphei, Kim, Nain, Chander K, Singh, Kartar
• Format: Article
• Language: English
• Subjects: Abdominal Pain - epidemiology; Adolescent; Adult; Anemia - epidemiology; Autoantibodies - blood; Biological and medical sciences; Biopsy; celiac disease; Celiac Disease - diet therapy; Celiac Disease - epidemiology; Celiac Disease - immunology; Celiac Disease - pathology; Child; Child, Preschool; diabetes mellitus; Diabetes Mellitus, Type 1 - epidemiology; Diabetes. Impaired glucose tolerance; Diarrhea - epidemiology; Diet, Gluten-Free; Duodenoscopy; Duodenum - pathology; Early Diagnosis; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Gastroenterology. Liver. Pancreas. Abdomen; Growth Disorders - epidemiology; GTP-Binding Proteins; Humans; India - epidemiology; Male; Medical sciences; Other diseases. Semiology; Predictive Value of Tests; Prevalence; Retrospective Studies; short stature; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Time Factors; Transglutaminases - immunology; Treatment Outcome; Weight Loss; Young Adult
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2010.06508.x

Background and Aim:  There is scanty data on the occurrence of celiac disease in patients with type 1 diabetes mellitus in South Asia. Our aim was to study the prevalence and clinical profile of celiac disease in patients with type 1 diabetes mellitus in a tertiary care referral centre in north India. Methods:  Consecutive patients of type 1 diabetes mellitus attending the Endocrine clinic of our institute between January 2002 and December 2008 were screened using anti‐tissue transglutaminase antibodies (tTGAb), and those positive were subjected to duodenal biopsy. Clinical profile of these patients was recorded. Results:  Out of 189 patients of type 1 diabetes mellitus, 21 (11.1%) were diagnosed to have celiac disease on the basis of positive serology (tTGAb) and duodenal histology. The mean age at diagnosis of diabetes was 10.81 ± 7.3 years and that of celiac disease was 13.74 ± 5.71 years, with a difference of 5.18 ± 4.75 years between the two. Only 2/21 patients with celiac disease had been diagnosed before detection of diabetes mellitus. Short stature was the commonest (52.3%) manifestation of celiac disease, followed by anemia (47.3), weight loss (42.8%), diarrhea (28.6%) and abdominal pain (14.2%). After initiating gluten free diet, 14/16 symptomatic patients had reversal of anemia, weight loss and diarrhea. Growth rate velocity improved from 2.3 ± 1.0 cm/year to 5.5 ± 2.4 cm/year in those with short stature. Conclusion:  Celiac disease is highly prevalent in patients with type 1 diabetes mellitus (11.1%) and majority of them (90.5%) were diagnosed on screening. Routine screening is required for early diagnosis and combat associated co‐morbidities.