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. 2024 Apr 1;47(4):756-760.
doi: 10.2337/dc23-1671.

Prevalence and Predictive Factors for Celiac Disease in Children With Type 1 Diabetes: Whom and When to Screen? A Nationwide Longitudinal Cohort Study of Swedish Children

Marie Lindgren  1   2 , Fredrik Norström  3 , Martina Persson  4 , Helena Elding Larsson  5   6 , Gun Forsander  7   8 , Karin Åkesson  9   10 , Ulf Samuelsson  9   11 , Johnny Ludvigsson  9   11 , Annelie Carlsson  1   6
Affiliations

Prevalence and Predictive Factors for Celiac Disease in Children With Type 1 Diabetes: Whom and When to Screen? A Nationwide Longitudinal Cohort Study of Swedish Children

Marie Lindgren et al. Diabetes Care. .

Abstract

Objective: To examine the prevalence and predictive factors for celiac disease (CD) after a diagnosis of type 1 diabetes (T1D) in children and adolescents, to improve the current screening guidelines.

Research design and methods: The association between sex, age at T1D diagnosis, HLA, and diabetes autoantibodies, and a diagnosis of CD was examined in 5,295 children with T1D from the Better Diabetes Diagnosis study in Sweden.

Results: The prevalence of biopsy-proven CD was 9.8%, of which 58.2% already had a CD diagnosis before or at T1D onset. Almost all, 95.9%, were diagnosed with CD within 5 years after the T1D diagnosis. Younger age at the T1D diagnosis and being homozygote for DQ2 increased the risk of CD after T1D, but neither sex nor diabetes-related autoantibodies were associated with the risk.

Conclusions: Age at and time after diabetes diagnosis should be considered in screening guidelines for CD in children with T1D.

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Conflict of interest statement

Duality of Interest. No potential conflicts of interest relevant to this article were reported.

Figures

None
Graphical abstract
Figure 1
Figure 1
Flowchart of inclusion and exclusion criteria in the study population and the prevalence of CD in the different groups based on when CD is diagnosed in relation to T1D diagnosis.1BDD, Better Diabetes Diagnosis study. 2NPR, Swedish National Patient Register. 3BDD1, children included in BDD between May 2005 and December 2010. 4BDD2, children included in BDD from January 2011 until December 2012.
Figure 2
Figure 2
Yearly incidence of CD after T1D diagnosis. “Year after T1D diagnosis” represents the year screening took place (e.g., year 0 = children screened at T1D diagnosis and CD diagnosed within the first year after T1D diagnosis, and year 1 = children screened 1 year after T1D diagnosis and CD diagnosed between the first and second year after T1D diagnosis etc.). Follow-up began at T1D diagnosis and ended at CD diagnosis, 18 years of age, or study period completion, meaning that the oldest age-groups did not have a 10-year follow-up time.
See this image and copyright information in PMC

References

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