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. 2021 Apr;110(4):1353-1358.
doi: 10.1111/apa.15643. Epub 2020 Nov 18.

Comorbidity of inflammatory bowel disease in children and adolescents with type 1 diabetes

Hildegard Jasser-Nitsche  1 , Susanne Bechtold-Dalla Pozza  2 , Elisabeth Binder  3 , Esther Bollow  4 , Bettina Heidtmann  5 , Young Hee Lee-Barkley  6 , Klemens Raile  7 , Gideon de Sousa  8 , Ursula Schramm  9 , Reinhard W Holl  4
Affiliations

Comorbidity of inflammatory bowel disease in children and adolescents with type 1 diabetes

Hildegard Jasser-Nitsche et al. Acta Paediatr. 2021 Apr.

Abstract

Aim: To determine the prevalence of inflammatory bowel disease (IBD) in patients with type 1 diabetes (T1D) and to characterise patients with both diseases.

Methods: Data of 65.147 patients with T1D ≤18 years of 379 centres in Germany and Austria participating in the DPV initiative were analysed. A total of 63 children had comorbid IBD; IBD prevalence was 0.1%. Regression models were used to analyse differences in metabolic control, acute complications and steroid intake.

Results: Mean BMI-SDS in patients with T1D and IBD was lower (-0.15 ± 0.11) compared to patients with T1D only (0.27 ± 0.00, p < .001). Patients with T1D and IBD had a significantly higher use of steroids (22% ± 0.05% vs. 1% ± 0.00, p < .001) and a significantly higher rate of severe hypoglycaemic events per patient year (0.33 ± 0.07 vs. 0.16 ± 0.00, p = .001). No differences were found in HbA1c levels, insulin dose and occurrence of DKA.

Conclusion: Although children and adolescents with T1D and IBD take steroids more often, they suffer from severe hypoglycaemia more frequently and have a lower BMI-SDS. These findings might be explained by chronic intestinal inflammation leading to malabsorption, malnutrition and increased severe hypoglycaemia.

Keywords: children; hypoglycaemia; inflammatory bowel disease; prevalence; type 1 diabetes.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Selection of patients
FIGURE 2
FIGURE 2
Acute complications (adjusted for age, sex and diabetes duration)
See this image and copyright information in PMC

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