Prevalence and Predictive Factors for Celiac Disease in Children With Type 1 Diabetes: Whom and When to Screen? A Nationwide Longitudinal Cohort Study of Swedish Children

Diabetes Care. 2024 Apr 1;47(4):756-760. doi: 10.2337/dc23-1671.

Abstract

Objective: To examine the prevalence and predictive factors for celiac disease (CD) after a diagnosis of type 1 diabetes (T1D) in children and adolescents, to improve the current screening guidelines.

Research design and methods: The association between sex, age at T1D diagnosis, HLA, and diabetes autoantibodies, and a diagnosis of CD was examined in 5,295 children with T1D from the Better Diabetes Diagnosis study in Sweden.

Results: The prevalence of biopsy-proven CD was 9.8%, of which 58.2% already had a CD diagnosis before or at T1D onset. Almost all, 95.9%, were diagnosed with CD within 5 years after the T1D diagnosis. Younger age at the T1D diagnosis and being homozygote for DQ2 increased the risk of CD after T1D, but neither sex nor diabetes-related autoantibodies were associated with the risk.

Conclusions: Age at and time after diabetes diagnosis should be considered in screening guidelines for CD in children with T1D.

MeSH terms

  • Adolescent
  • Autoantibodies
  • Celiac Disease* / complications
  • Celiac Disease* / diagnosis
  • Celiac Disease* / epidemiology
  • Child
  • Cohort Studies
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / epidemiology
  • Humans
  • Infant
  • Longitudinal Studies
  • Prevalence
  • Sweden / epidemiology

Substances

  • Autoantibodies