Holmes Geoffrey, Gillett Peter
Department of Gastroenterology, Royal Derby Hospital, Derby DE22 3NE, UK.
Department of Paediatric Gastroenterology, Royal Hospital for Children and Young People, Edinburgh EH16 4TJ, UK.
J Clin Med. 2025 Jul 18;14(14):5129. doi: 10.3390/jcm14145129.
T1D and CD commonly occur together. This association has received increasing attention from researchers and is considered in detail in this review. Since CD is over-represented in T1D, it may cause ill health with attendant complications, but because there is an effective dietary treatment, screening has been recommended in children and adults. However, there are many unknowns regarding this association, and understanding the why, when, and how with regard to screening and managing those with dual diagnoses requires thorough consideration when introducing the concept of screening to patients. It is important that patients and, where appropriate, carers are put at the heart of the decision-making process with careful discussion of the issues involved before undertaking screening that might uncover a second life-changing diagnosis, for which, without preparatory preparation and support, individuals may be ill-prepared, causing mental health issues. For some patients, an initial policy of monitoring rather than moving to immediate small bowel biopsy and exposure to a gluten-free diet (GFD) will be appropriate. The correct management of patients will ultimately improve their quality of life medically and socially.
1型糖尿病（T1D）和乳糜泻（CD）常同时出现。这种关联已受到研究人员越来越多的关注，本综述将对此进行详细探讨。由于CD在T1D中比例过高，它可能导致健康问题及相关并发症，但鉴于存在有效的饮食治疗方法，因此建议对儿童和成人进行筛查。然而，关于这种关联仍有许多未知之处，在向患者介绍筛查概念时，对于双重诊断患者的筛查原因、时间和方式，需要进行全面考虑。重要的是，在进行可能揭示另一种改变生活的诊断的筛查之前，要让患者以及在适当情况下让护理人员参与决策过程的核心，仔细讨论相关问题。因为如果没有预先准备和支持，个人可能对此毫无准备，从而引发心理健康问题。对于一些患者来说，最初采用监测策略而非立即进行小肠活检并采用无麸质饮食（GFD）是合适的。对患者的正确管理最终将在医学和社会层面改善他们的生活质量。
