Annual Celiac Disease Test Urged in Type 1

COPENHAGEN — Children who are newly diagnosed with type 1 diabetes should be screened annually for celiac disease for at least 3 years and not just at diagnosis, according to Dr. Karin Larsson of Kristianstad (Sweden) Hospital.

Study findings, which were presented at annual meeting of the European Association for the Study of Diabetes, were based on 300 patients under age 20 (mean age 10 years) who were newly diagnosed with type 1 diabetes at six different pediatric diabetes centers in Sweden. Serum IgA-antiendomysium antibody (EMA) testing was done at baseline to screen for celiac disease and, if negative, testing was repeated annually for 5 years. Patients with a positive blood screening test then underwent intestinal biopsy to confirm celiac disease.

At the end of the 5-year study, 29 diabetes patients (10%) had been diagnosed with celiac disease after their diagnosis of diabetes. Two had preexisting celiac disease before their diagnosis of diabetes—one patient 2 years earlier; the other,10 years earlier. Twelve patients had a positive EMA test at the time of their diabetes diagnosis followed by biopsy confirmation of celiac disease. In the first year after the diabetes diagnosis, another 10 patients were diagnosed with celiac disease; another 5 were diagnosed in the second year. One more patient was diagnosed in year 3 and a final one in the fifth year. Of those diagnosed with celiac disease, 59% had no symptoms.