Anna Taczanowska1, Anke Schwandt2,3, Shazhan Amed4, Péter Tóth-Heyn5, Christina Kanaka-Gantenbein6, Sari Krepel Volsky7, Jannet Svensson8, Agnieszka Szypowska1. 1. Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland. 2. Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany. 3. German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany. 4. Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada. 5. Ist Department of Pediatrics, Semmelweis University, Budapest, Hungary. 6. Agia Sophia Children's Hospital, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Athens, Greece. 7. Schneider Children's Medical Center of Israel, Endocrinology and Diabetes, Petah Tikva, Israel. 8. Department of Pediatrics and Adolescents, Copenhagen University Hospital, Herlev, Denmark.
Abstract
BACKGROUND: Children 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. METHODS: This 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. RESULTS: CD 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. CONCLUSIONS: The prevalence and the anthropometric and metabolic consequences of CD in children with T1D differ around the world.
BACKGROUND:Children 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. METHODS: This 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. RESULTS: CD 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. CONCLUSIONS: The prevalence and the anthropometric and metabolic consequences of CD in children with T1D differ around the world.