Celiac disease in children with type 1 diabetes varies around the world: An international, cross‐sectional study of 57 375 patients from the SWEET registry

• DOI: 10.1111/1753-0407.13126
• Publication Date: 2020-10-29T09:39:35Z
• Authors: Anna Taczanowska; Anke Schwandt; Shazhan Amed; Péter Tóth‐Heyn; Christina Kanaka‐...; Sari Krepel Volsky; Jannet Svensson; Agnieszka Szypowska
• Keywords: Male; Adolescent; 610; Risk Assessment; 03 medical and health sciences; Insulin Infusion Systems; 0302 clinical medicine; Prevalence; Humans; Hypoglycemic Agents; Insulin; Prospective Studies; Registries; Age of Onset; Healthcare Disparities; Child; Health Status Disparities; Prognosis; 3. Good health; Celiac Disease; Cross-Sectional Studies; Diabetes Mellitus, Type 1; Child, Preschool; Female

AbstractBackgroundChildren with type 1 diabetes (T1D) are at much higher risk of developing celiac disease (CD) than the general population. The aim of the study was to assess the prevalence and differences in clinical presentation of CD in T1D in different regions of the world.MethodsThis study is based on the Better control in Pediatric and Adolescent diabeteS: Working to crEate cEnTers of Reference (SWEET) database. There were 57 375 patients included in the study, aged ≤18 years from 54 SWEET centers. Only centers with screening for celiac disease were included. Regression models adjusted for age, diabetes duration, and gender and a fixed effect in the models for region was used. Diabetes duration, age at diabetes onset, and sex were presented as unadjusted results.ResultsCD was present in 2652 subjects (4.5%), with different prevalence among regions: from 1.9% in Asia/Middle East to 6.9% in Australia/New Zealand. CD was observed more often among females. Comparing children with and without CD, characteristics for those with CD were younger age at diabetes onset (6.3 [3.3; 9.8] vs 8.1 [4.6; 11.3], P < 0.001) and had longer diabetes duration (6.4 [3.6; 9.8] vs 4.8 [2.1; 8.2], P < 0.001). Further, they had lower glycosylated hemoglobin (HbA1c) in Europe and North America/Canada; lower body mass index (BMI)‐SD score (BMI‐SDS) in southern Europe, North America, and Canada; In most regions daily insulin dose was lower, height‐SDS was lower, and the percentage of insulin pump users was higher in children with T1D and CD.ConclusionsThe prevalence and the anthropometric and metabolic consequences of CD in children with T1D differ around the world.