Comment on Castellaneta et al. High Rate of Spontaneous Normalization of Celiac Serology in a Cohort of 446 Children With Type 1 Diabetes: A Prospective Study. Diabetes Care 2015;38:760–766

Maltoni, Giulio; Salardi, S; Zucchini, Stefano

doi:10.2337/dc15-1208

Cited by 1 publication

(1 citation statement)

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“…Family history of CD, high antibody titer and EMA positivity should suggest further investigation. Spontaneous normalization of celiac serology in T1DM has been suggested to be an epiphenomenon of the autoimmune activation (22).…”

Section: Methodsmentioning

confidence: 99%

Celiac Disease and Diabetes

Weiss

Pinhas‐Hamiel

2017

J. pediatr. gastroenterol. nutr.

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Prevalence studies from around the world have established a substantial increase in the prevalence of celiac disease (CD) in patients with type 1 diabetes mellitus (T1DM). Approximately two-thirds of patients with T1DM and CD are asymptomatic for CD at diagnosis. We aim to provide an up-to-date state-of-the-art summary of the recommendations for serologic testing for CD in patients with T1DM and to clarify the debate on the need for screening and interventions. We searched Medline and Cochrane databases for studies of celiac autoimmunity and biopsy-proven CD in people with T1DM between January 1, 2000 and December 1, 2015. CD was found to be an independent risk factor for micro- and macrovascular complications, as well as for increased morbidity in patients with T1DM. Publications, however, reveal controversy regarding the benefits of a gluten-free diet (GFD) on glycemic control, bone health, and quality of life in individuals with T1DM and asymptomatic CD. A multicenter, prospective randomized controlled trial aimed to investigate this issue is currently ongoing. Until resolution of the pros and cons of screening for CD, and of the benefit versus burden of GFD treatment in T1DM patients with asymptomatic CD, we recommend repeated screening for CD during childhood and adulthood, and treatment with GFD for those with biopsy-proven CD, even if asymptomatic.

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Section: Methodsmentioning

confidence: 99%