FREQUENCY OF DIABETES IN CHILDREN DIAGNOSED WITH CELIAC DISEASE AND THEIR GLYCEMIC CONTROL

Abstract

Background: Celiac disease (CD) and type 1 diabetes (T1D) are both autoimmune disorders, and children diagnosed with CD may be at an increased risk of developing T1D. Objective: This study aimed to assess the incidence of type 1 diabetes in children with celiac disease and to evaluate their glycemic control using postprandial glucose (PPG) levels and HbA1c measurements. Methods: This cross-sectional observational study was conducted at CNH, Lahore, from July 2023 to January 2024. The study included a total of 115 pediatric patients who were diagnosed with celiac disease. Data were collected by clinical evaluations and laboratory tests. All patients were examined by pediatric gastroenterologists and endocrinologists to assess their medical history, adherence to a gluten-free diet, and symptoms associated with celiac disease or diabetes. Results: Out of the 115 children with celiac disease, 8 (7%) were diagnosed with type 1 diabetes based on abnormal PPG levels. Additionally, 12 children (10%) had HbA1c levels greater than 6.5%, indicating suboptimal glycemic control, with 8 of them diagnosed with T1D and 4 with elevated HbA1c levels but without a T1D diagnosis. Strict adherence to the gluten-free diet was associated with significantly better glycemic control (mean HbA1c of 5.8%) compared to those with moderate (6.4%) or poor adherence (7.0%). Conclusions: Children with celiac disease are at an increased risk for developing type 1 diabetes, and regular screening for diabetes using postprandial glucose and HbA1c levels is essential. Strict adherence to a gluten-free diet is crucial for maintaining optimal glycemic control and preventing the onset of diabetes.