Compliance to a Gluten-Free Diet in Swedish Children with Type 1 Diabetes and Celiac Disease

Söderström, HannaLund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital (author)

Children with type 1 diabetes (T1D) are at increased risk of celiac disease (CD). The replacement of insulin in T1D, and the exclusion of gluten in CD, are lifelong, burdensome treatments. Compliance to a gluten-free diet (GFD) in children with CD is reported to be high, while compliance in children with both diseases has scarcely been studied. To examine compliance to a GFD in children with both T1D and CD, we analyzed tissue transglutaminase IgA-antibodies (tTGA). Moreover, associations between compliance and age, sex, glycemic control, ketoacidosis (DKA), body mass index (BMI), and time of CD diagnosis were investigated. Of the 743 children diagnosed with T1D in southern Sweden between 2005 and 2012, 9% were also diagnosed with CD. Of these, 68% showed good compliance to a GFD, 18% showed intermediate compliance, and 14% were classified as non-compliant. Higher age, poorer HbA1c, and more DKAs were significantly (p < 0.05) associated with poorer compliance. In conclusion, we found that compliance to a GFD in children with T1D and CD is likely be lower than in children with CD only. Our results indicate that children with both T1D and CD could need intensified dietary support and that older children and children with poor metabolic control are especially vulnerable subgroups.

Rehn, JuliaLund University (author)
Cervin, MattiLund University,Lunds universitet,Neurokognitiva funktioner och psykopatologi hos barn och ungdomar,Forskargrupper vid Lunds universitet,Brain function and behavioral mechanisms in psychopathology,Lund University Research Groups(Swepub:lu)ma8505ce (author)
Ahlstermark, CathrineSkåne University Hospital (author)
Cerqueiro Bybrant, MaraKarolinska Institutet (author)
Carlsson, AnnelieLund University,Lunds universitet,Pediatrisk autoimmunitet,Forskargrupper vid Lunds universitet,Pediatric Autoimmunity,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-acs (author)
Pediatrik, LundSektion V (creator_code:org_t)

By the author/editor: Söderström, Hann ...; Rehn, Julia; Cervin, Matti; Ahlstermark, Cat ...; Cerqueiro Bybran ...; Carlsson, Anneli ...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Pediatrics

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Endocrinology an ...

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