Screening for coeliac disease in adult patients with type 1 diabetes mellitus: myths, facts and controversy

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Abstract

This review aims at summarizing the present knowledge on the clinical consequences of concomitant coeliac disease (CD) in adult patients with type 1 diabetes mellitus (T1DM). The cause of the increased prevalence of CD in T1DM patients is a combination of genetic and environmental factors. Current screening guidelines for CD in adult T1DM patients are not uniform. Based on the current evidence of effects of CD on bone mineral density, diabetic complications, quality of life, morbidity and mortality in patients with T1DM, we advise periodic screening for CD in adult T1DM patients to prevent delay in CD diagnosis and subsequent CD and/or T1DM related complications.

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Most cited references 83

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The prevalence of comorbid depression in adults with diabetes: a meta-analysis.

Judy Anderson, P Lustman, Melvin E. Clouse … (2001)

To estimate the odds and prevalence of clinically relevant depression in adults with type 1 or type 2 diabetes. Depression is associated with hyperglycemia and an increased risk for diabetic complications; relief of depression is associated with improved glycemic control. A more accurate estimate of depression prevalence than what is currently available is needed to gauge the potential impact of depression management in diabetes. MEDLINE and PsycINFO databases and published references were used to identify studies that reported the prevalence of depression in diabetes. Prevalence was calculated as an aggregate mean weighted by the combined number of subjects in the included studies. We used chi(2) statistics and odds ratios (ORs) to assess the rate and likelihood of depression as a function of type of diabetes, sex, subject source, depression assessment method, and study design. A total of 42 eligible studies were identified; 20 (48%) included a nondiabetic comparison group. In the controlled studies, the odds of depression in the diabetic group were twice that of the nondiabetic comparison group (OR = 2.0, 95% CI 1.8-2.2) and did not differ by sex, type of diabetes, subject source, or assessment method. The prevalence of comorbid depression was significantly higher in diabetic women (28%) than in diabetic men (18%), in uncontrolled (30%) than in controlled studies (21%), in clinical (32%) than in community (20%) samples, and when assessed by self-report questionnaires (31%) than by standardized diagnostic interviews (11%). The presence of diabetes doubles the odds of comorbid depression. Prevalence estimates are affected by several clinical and methodological variables that do not affect the stability of the ORs.

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John Bantle, Judith Wylie-Rosett, Ann Albright … (2008)

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Shared and distinct genetic variants in type 1 diabetes and celiac disease.

Deborah J Smyth, Vincent Plagnol, Neil M Walker … (2009)

Two inflammatory disorders, type 1 diabetes and celiac disease, cosegregate in populations, suggesting a common genetic origin. Since both diseases are associated with the HLA class II genes on chromosome 6p21, we tested whether non-HLA loci are shared. We evaluated the association between type 1 diabetes and eight loci related to the risk of celiac disease by genotyping and statistical analyses of DNA samples from 8064 patients with type 1 diabetes, 9339 control subjects, and 2828 families providing 3064 parent-child trios (consisting of an affected child and both biologic parents). We also investigated 18 loci associated with type 1 diabetes in 2560 patients with celiac disease and 9339 control subjects. Three celiac disease loci--RGS1 on chromosome 1q31, IL18RAP on chromosome 2q12, and TAGAP on chromosome 6q25--were associated with type 1 diabetes (P<1.00x10(-4)). The 32-bp insertion-deletion variant on chromosome 3p21 was newly identified as a type 1 diabetes locus (P=1.81x10(-8)) and was also associated with celiac disease, along with PTPN2 on chromosome 18p11 and CTLA4 on chromosome 2q33, bringing the total number of loci with evidence of a shared association to seven, including SH2B3 on chromosome 12q24. The effects of the IL18RAP and TAGAP alleles confer protection in type 1 diabetes and susceptibility in celiac disease. Loci with distinct effects in the two diseases included INS on chromosome 11p15, IL2RA on chromosome 10p15, and PTPN22 on chromosome 1p13 in type 1 diabetes and IL12A on 3q25 and LPP on 3q28 in celiac disease. A genetic susceptibility to both type 1 diabetes and celiac disease shares common alleles. These data suggest that common biologic mechanisms, such as autoimmunity-related tissue damage and intolerance to dietary antigens, may be etiologic features of both diseases. 2008 Massachusetts Medical Society

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Author and article information

Contributors

Sjoerd F. Bakker: sf.bakker1@vumc.nl

Maarten E. Tushuizen: sf.bakker1@vumc.nl

Boudewina M. E. von Blomberg: sf.bakker1@vumc.nl

Hetty J. Bontkes: sf.bakker1@vumc.nl

Chris J. Mulder: sf.bakker1@vumc.nl

Suat Simsek: sf.bakker1@vumc.nl

Journal

Journal ID (nlm-ta): Diabetol Metab Syndr

Journal ID (iso-abbrev): Diabetol Metab Syndr

Title: Diabetology & Metabolic Syndrome

Publisher: BioMed Central (London )

ISSN (Electronic): 1758-5996

Publication date (Electronic): 29 July 2016

Publication date PMC-release: 29 July 2016

Publication date Collection: 2016

Volume: 8

Electronic Location Identifier: 51

Affiliations

[1 ]Department of Gastroenterology and Hepatology, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands

[2 ]Department of Pathology, Unit Medical Immunology, VU University Medical Centre, Amsterdam, The Netherlands

[3 ]Department of Internal Medicine, North West Clinics, Alkmaar, The Netherlands

[4 ]Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands

Article

Publisher ID: 166

DOI: 10.1186/s13098-016-0166-0

PMC ID: 4966870

PubMed ID: 27478507

SO-VID: a3124d3f-c2ff-4159-a626-34c12060a232

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 25 January 2016

Date accepted : 10 July 2016

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ScienceOpen disciplines: Nutrition & Dietetics

Keywords: coeliac disease,clinical characteristics,gluten free diet,screening,quality of life,tissue-transglutaminase antibodies,complications and type 1 diabetes mellitus

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ScienceOpen disciplines: Nutrition & Dietetics

Keywords: coeliac disease, clinical characteristics, gluten free diet, screening, quality of life, tissue-transglutaminase antibodies, complications and type 1 diabetes mellitus

Screening for coeliac disease in adult patients with type 1 diabetes mellitus: myths, facts and controversy

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Most cited references 83

The prevalence of comorbid depression in adults with diabetes: a meta-analysis.

Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association.

Shared and distinct genetic variants in type 1 diabetes and celiac disease.

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