Background. Celiac disease is frequently associated with type 1 diabetes mellitus, but is usually ill-defined and not usually suspected until the disease becomes advanced.

Background. Celiac disease is frequently associated with uncontrolled blood sugar and impaired linear growth in a child with type 1 diabetes mellitus.Objective. To study the impact of a gluten-free diet on several growth parameters in children with type 1 diabetes mellitus and celiac disease.Methodology. Two hundred and fifty six patients with Type 1 diabetes mellitus were screened (149 males and 107 females) during the study period of two years. Patients were evaluated for the clinical signs, biochemical investigations and family history of celiac disease in a tertiary care health centre in Western Uttar Pradesh, India.Results. Twenty four (9.3%) patients were diagnosed to have celiac disease; the mean age at diagnosis of diabetes was 9.3±7 years. Only one out of twenty four patients with celiac disease had been diagnosed before the detection of diabetes mellitus. Weight standard deviation score (SDS) increased from -0.12+1.3 at the start of gluten free diet to 0.8+0.9 after 12 months (p<0.004). Height SDS decreased from -2.46+1.1 at the start of gluten free diet to -2.14+0.9 after 12 months later (p=0.087). Bone age SDS increased from 9.2+6.3 at the start of gluten free diet to 10.3+6.7 after 12 months later. Height velocity increased from 4.7+0.7 cm/year in the year before treatment to 5.1+1.2 cm/year during treatment (p=0.05). The increase in Haemoglobin, serum calcium, and serum iron was statistically significant (p<0.05). Conclusion.Patients with celiac disease associated with type 1 diabetes mellitus frequently have poor glycemic control and impairment in several growth parameters. When these patients are put on a gluten restricted diet, they show signs of improvement in terms of weight gain, height, serum Ca, serum iron, haemoglobin, and in height velocity.

Drugs raise blood glucose concentrations via two broad mechanisms: By reducing insulin biosynthesis or secretion, or by reducing tissue sensitivity to insulin. Until date, there have been very few reported cases of isoniazid induced diabetes. We are presenting a case report of 6-year-old child with isoniazid induced diabetes who was misdiagnosed initially as a case of type 1 diabetes mellitus. We hereby stress that before diagnosing a patient with diabetes-type 1 or 2, a detailed history of drug intake for any such drugs, which can cause hyperglycemia has to be taken. Clear cut knowledge/cognizance of all such culprit drugs is therefore required.

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