Incidence and risk of celiac disease after type 1 diabetes: A population‐based cohort study using the health improvement network database

Abstract

As expected, incidence of CD was higher in individuals with childhood-onset diabetes vs those with adult-onset diabetes. However, individuals with diabetes are at risk of developing CD throughout childhood and adulthood, and prolonged screening after diagnosis may be warranted. Prospective studies are needed in order to guide risk-stratified approaches to screening.

Celiakijos Ir 1 Tipo Cukrinio Diabeto Ryšys

“…Be anksčiau minėtos genetinės predispozicijos, nustatyti prognostiniai veiksniai, leidžiantys prognozuoti tikimybę išsivystyti celiakijai, sergant 1 tipo CD. Remiantis literatūros šaltiniais, moteriška lytis (šansų santykis (ŠS) skirtingoje literatūroje varijuoja tarp 1,26 ir 3,19), nustatyta hipotirozė (ŠS varijuoja tarp 2,37 ir 6,4), amžius, kai buvo nustatytas 1 tipo CD (ŠS = 0,51, kai amžius >10 m. ir ŠS = 1,7, kai amžius <5 m.), žemesnis ūgis (ŠS 3,16), celiakijos anamnezė šeimoje (ŠS = 2,6) lemia didesnę celiakijos išsivystymo tikimybę [4,[9][10][11][12][13]. Nustatyta, jog sunkesnės celiakijos simptomatikos pasireiškimas bei jaunesnis amžius, kai buvo nustatytas 1 tipo CD, buvo reikšmingi veiksniai, leidžiantys prognozuoti teigiamus celiakijos serologinių tyrimų rezultatus [9].…”

“…Be to, didėja diabeto komplikacijų rizika jaunesniame amžiuje. Remiantis nagrinėta literatūra, rizika išsivystyti retinopatijai yra 1,263[95% Cl 1,078 -1,481], o nefropatijai -1,359 [1,228 -1,504] didesnė sergant 1 tipo CD ir celiakija, lyginant su sergančiaisiais tik CD [3,5,6,10].…”

<p>The Challenges of Identifying Environmental Determinants of Type 1 Diabetes: In Search of the Holy Grail</p>

“…Several databases and electronic medical records have been used in type 1 diabetes research including the Swedish National Diabetes Register, 35 the Danish Adult Diabetes Database, 36 the Scottish Care Information-Diabetes Collaboration (SCI-DC) database 37 and The Health Improvement Network (THIN). 38 Disadvantages of databases include that they are limited to the variables collected, the way the variables are collected (ie data may be collected by category rather than as a continuous variable), lacking in rich clinical detail, and expensive to create, maintain, and manage. Furthermore, studies that use large diabetes databases are often a secondary analysis of data collected for other purposes.…”

Possible Prevention of Diabetes with a Gluten-Free Diet

“…During the recent years, there has been a tremendous increase in the number of GF products available with the promise of diverse health benefits. The incidence of celiac disease (CD) was estimated to be 33.6 per 10,000 person-years in a recent retrospective cohort study from the United Kingdom [ 1 ]. Non-celiac gluten sensitivity is thought to be more common, although the precise number is unknown [ 2 , 3 , 4 , 5 ].…”

“…Interestingly, human studies indicate that T1D and CD are comorbid diseases and they share the genetically predisposing haplotypes HLA-DQ2/DQ8. The risk of developing other autoimmune diseases is increased for patients with CD, in particular for those diagnosed early (<16 years of age [ 87 ]) (<18 years of age [ 1 ]). The prevalence of CD is 5–10% in patients with T1D [ 88 , 89 , 90 , 91 , 92 ]; however, the risk is lower in patients compliant to a GF diet [ 87 ].…”