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Prevalence of celiac disease in Indian children with type 1 diabetes

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Abstract

Background

Type 1 diabetes (T1D) patients are at an increased risk of having celiac disease (CD). We evaluated the prevalence and clinical profile of CD in children and adolescents with T1D and reviewed the Indian literature to determine prevalence and reasons for variability.

Methods

In this cross-sectional study, subjects with T1D were prospectively evaluated with a demographic and gastrointestinal (GI) questionnaire, human IgA-tissue transglutaminase (IgA-tTGA), and endoscopic duodenal biopsy in serology positive patients. Studies evaluating prevalence of CD in T1D from India were reviewed.

Results

Fourteen (13.6 %) of the 103 (52 boys, 13 years [2–20]) T1D patients were IgA-tTGA (182 U [47–300]) positive and 3.8 % (4/103) had villous atrophy on histology. Subjects with T1D and CD (n = 4) were younger at onset of T1D (32.5 ± 12.6 vs. 110.5 ± 53.8 months; p < 0.005) and more often had GI symptoms (pain abdomen [2/4 vs. 6/89; p = 0.01], stool frequency of 2–3/day [3/4 vs. 38/89; p = 0.004]) than screen negative T1D (n = 89). Growth and glycemic control were not different between the groups. In the 7 Indian studies involving 915 children and adults, 13.8 % (8 % to 17.8 %) T1D were serology positive. Prevalence of CD was reported as 6.9 % (2.3 % to 11.1 %), but only 3.1 % (2.3 % to 4.2 %) had villous atrophy on histology.

Conclusions

Potential CD and CD were present in 13.6 % and 3.8 % children with T1D respectively. T1D with CD have onset of diabetes at younger age and were more often symptomatic than screen negative T1D.

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Authors and Affiliations

  1. Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India

    Anshu Srivastava, Saurabh Chaturvedi, Amrita Mathias, Umesh Shukla & Surender Kumar Yachha

  2. Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India

    Preeti Dabadghao

  3. Department of Biostatistics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India

    Uttam Singh

Authors
  1. Anshu Srivastava
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  2. Saurabh Chaturvedi
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  3. Preeti Dabadghao
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  5. Umesh Shukla
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  7. Surender Kumar Yachha
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Correspondence to Anshu Srivastava.

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Conflict of interest

AS, SC, PD, AM, US, US, and SKY declare that they have no conflict of interest.

Ethics statement

The study was performed in a manner to conform with the Helsinki declaration of 1975, as revised in 2000 and 2008, concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Funding

The study was funded by an intramural grant from SGPGIMS, Lucknow, India.

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Srivastava, A., Chaturvedi, S., Dabadghao, P. et al. Prevalence of celiac disease in Indian children with type 1 diabetes. Indian J Gastroenterol 35, 372–378 (2016). https://doi.org/10.1007/s12664-016-0692-6

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  • DOI: https://doi.org/10.1007/s12664-016-0692-6

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