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Prevalence of Celiac Disease in 52,721 youth with type 1 diabetes: International comparison across three continents

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dc.contributor.authorCraig, M.E.
dc.contributor.authorPrinz, N.
dc.contributor.authorBoyle, C.T.
dc.contributor.authorCampbell, F.M.
dc.contributor.authorJones, T.W.
dc.contributor.authorHofer, S.E.
dc.contributor.authorSimmons, J.H.
dc.contributor.authorHolman, N.
dc.contributor.authorTham, E.
dc.contributor.authorFröhlich-Reiterer, E.
dc.contributor.authorDuBose, S.
dc.contributor.authorThornton, H.
dc.contributor.authorKing, B.
dc.contributor.authorMaahs, D.M.
dc.contributor.authorHoll, R.W.
dc.contributor.authorWarner, J.T.
dc.date.issued2017
dc.description.abstractOBJECTIVE: Celiac disease (CD) has a recognized association with type 1 diabetes. We examined international differences in CD prevalence and clinical characteristics of youth with coexisting type 1 diabetes and CD versus type 1 diabetes only. RESEARCH DESIGN AND METHODS: Data sources were as follows: the Prospective Diabetes Follow-up Registry (DPV) (Germany/Austria); the T1D Exchange Clinic Network (T1DX) (U.S.); the National Paediatric Diabetes Audit (NPDA) (U.K. [England/Wales]); and the Australasian Diabetes Data Network (ADDN) (Australia). The analysis included 52,721 youths <18 years of age with a clinic visit between April 2013 and March 2014. Multivariable linear and logistic regression models were constructed to analyze the relationship between outcomes (HbA1c, height SD score [SDS], overweight/obesity) and type 1 diabetes/CD versus type 1 diabetes, adjusting for sex, age, and diabetes duration. RESULTS: Biopsy-confirmed CD was present in 1,835 youths (3.5%) and was diagnosed at a median age of 8.1 years (interquartile range 5.3–11.2 years). Diabetes duration at CD diagnosis was <1 year in 37% of youths, >1–2 years in 18% of youths, >3–5 years in 23% of youths, and >5 years in 17% of youths. CD prevalence ranged from 1.9% in the T1DX to 7.7% in the ADDN and was higher in girls than boys (4.3% vs. 2.7%, P < 0.001). Children with coexisting CD were younger at diabetes diagnosis compared with those with type 1 diabetes only (5.4 vs. 7.0 years of age, P < 0.001) and fewer were nonwhite (15 vs. 18%, P < 0.001). Height SDS was lower in those with CD (0.36 vs. 0.48, adjusted P < 0.001) and fewer were overweight/obese (34 vs. 37%, adjusted P < 0.001), whereas mean HbA1c values were comparable: 8.3 ± 1.5% (67 ± 17 mmol/mol) versus 8.4 ± 1.6% (68 ± 17 mmol/mol). CONCLUSIONS: CD is a common comorbidity in youth with type 1 diabetes. Differences in CD prevalence may reflect international variation in screening and diagnostic practices, and/or CD risk. Although glycemic control was not different, the lower height SDS supports close monitoring of growth and nutrition in this population.
dc.description.statementofresponsibilityMaria E. Craig, Nicole Prinz, Claire T. Boyle, Fiona M. Campbell, Timothy W. Jones, Sabine E. Hofer, Jill H. Simmons, Naomi Holman, Elaine Tham, Elke Elke Fröhlich-Reiterer, Stephanie DuBose, Helen Thornton, Bruce King, David M. Maahs, Reinhard W. Holl, and Justin T. Warner, on behalf of the Australasian Diabetes Data Network, ADDN, the T, D Exchange Clinic Network, T, DX, the National Paediatric Diabetes Audit, NPDA, and the Royal College of Paediatrics and Child Health, and the Prospective Diabetes Follow-up Registry, DPV, initiative ... Jennifer Couper and Alexia Pena Vargas
dc.identifier.citationDiabetes Care, 2017; 40(8):1034-1040
dc.identifier.doi10.2337/dc16-2508
dc.identifier.issn0149-5992
dc.identifier.issn1935-5548
dc.identifier.urihttp://hdl.handle.net/2440/129113
dc.language.isoen
dc.publisherAmerican Diabetes Association
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1045777
dc.rights© 2017 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals .org/content/license.
dc.source.urihttps://doi.org/10.2337/dc16-2508
dc.subjectAustralasian Diabetes Data Network (ADDN)
dc.subjectT1D Exchange Clinic Network (T1DX)
dc.subjectNational Paediatric Diabetes Audit (NPDA) and the Royal College of Paediatrics and Child Health
dc.subjectProspective Diabetes Follow-up Registry (DPV) initiative
dc.subjectHumans
dc.subjectCeliac Disease
dc.subjectDiabetes Mellitus, Type 1
dc.subjectBlood Glucose
dc.subjectRegistries
dc.subjectPrevalence
dc.subjectFollow-Up Studies
dc.subjectProspective Studies
dc.subjectComorbidity
dc.subjectAdolescent
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectAustralia
dc.subjectGermany
dc.subjectEngland
dc.subjectWales
dc.subjectFemale
dc.subjectMale
dc.subjectGlycated Hemoglobin
dc.titlePrevalence of Celiac Disease in 52,721 youth with type 1 diabetes: International comparison across three continents
dc.typeJournal article
pubs.publication-statusPublished

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