Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Diabetes Care. 2020 Jul;43(7):1553-1556. doi: 10.2337/dc19-1944. Epub 2020 Apr 28.
To describe celiac disease (CD) screening rates and glycemic outcomes of a gluten-free diet (GFD) in patients with type 1 diabetes who are asymptomatic for CD.
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 HbA and continuous glucose monitoring over 12 months.
Adults had higher CD-seropositivity rates than children (6.8% [95% CI 4.9-8.2%, = 1,298] vs. 4.7% [95% CI 3.4-5.9%, = 1,089], = 0.035) with lower rates of prior CD screening (6.9% vs. 44.2%, < 0.0001). Fifty-one participants were randomized to a GFD ( = 27) or GCD ( = 24). No HbA differences were seen between the groups (+0.14%, 1.5 mmol/mol; 95% CI -0.79 to 1.08; = 0.76), although greater postprandial glucose increases (4-h +1.5 mmol/L; 95% CI 0.4-2.7; = 0.014) emerged with a GFD.
CD is frequently observed in asymptomatic patients with type 1 diabetes, and clinical vigilance is warranted with initiation of a GFD.
描述 1 型糖尿病无症状患者的腹腔疾病（CD）筛查率和无麸质饮食（GFD）的血糖结果。
对无症状患者（8-45 岁）进行 CD 筛查。活检证实的 CD 参与者被随机分配到 GFD 或含麸质饮食（GCD）组，以评估 12 个月内 HbA 和连续血糖监测的变化。
成人的 CD 血清阳性率高于儿童（6.8%[95%CI 4.9-8.2%，=1298]比 4.7%[95%CI 3.4-5.9%，=1089]，=0.035），且 CD 筛查率较低（6.9%比 44.2%，<0.0001）。51 名参与者被随机分配到 GFD 组（=27）或 GCD 组（=24）。两组间 HbA 无差异（+0.14%，1.5mmol/mol；95%CI-0.79 至 1.08；=0.76），尽管 GFD 后餐后血糖升高更明显（4h+1.5mmol/L；95%CI 0.4-2.7；=0.014）。
1 型糖尿病无症状患者常伴有 CD，需要临床警惕并开始 GFD。
