Screening and Treatment Outcomes in Adults and Children with Type 1 Diabetes and Asymptomatic Celiac Disease: The CD-DIET Study
Research Design and Methods: Asymptomatic patients (8-45 years) were screened for CD. Biopsy-confirmed CD participants were randomized to GFD or gluten-containing diet (GCD) to assess changes in HbA1c and continuous glucose monitoring (CGM) over 12 months.
Results: Adults had higher CD-seropositivity rates than children (6.8%, 95%CI 4.9% to 8.2%, N=1298 vs. 4.7%; 95%CI 3.4% to 5.9%, N=1089, p=0.035) with lower rates of prior CD-screening (6.9% vs 44.2%, p<0.0001). 51 participants were randomized to a GFD (N=27) or GCD (N=24). No HbA1c differences were seen between groups (+0.14%, 1.5mmol/mol; 95%CI: -0.79 to 1.08; p=0.76) although greater post-prandial glucose increases (4-hr +1.5mmol/L; 95%CI: 0.4 to 2.7; p=0.014) emerged with a GFD.
Conclusions: CD is frequently observed in asymptomatic patients with type 1 diabetes and clinical vigilance is warranted with initiation of a GFD.