Recommendations: Pediatric Celiac Disease (Type 1 Diabetes) (1)
Recommendations for the care of children with type 1 diabetes and celiac disease are summarized in two slides1 Slide 1 of 2 Children with type 1 diabetes should be screened for celiac disease by measuring tissue transglutaminase or anti-endomysial antibodies, with documentation of normal total serum IgA levels, soon after the diagnosis of diabetes (E) Testing should be repeated in children with growth failure, failure to gain weight, weight loss, diarrhea, flatulence, abdominal pain, or signs of malabsorption, or in children with frequent unexplained hypoglycemia or deterioration in glycemic control (E) Celiac disease is an immune-mediated disorder that occurs with increased frequency in patients with type 1 diabetes (1–16% of individuals compared with 0.3–1% in the general population)1,2 Symptoms of celiac disease include diarrhea, weight loss or poor weight gain, growth failure, abdominal pain, chronic fatigue, malnutrition due to malabsorption, other gastrointestinal problems, and unexplained hypoglycemia or erratic blood glucose concentrations3 Screening for celiac disease includes measuring serum levels of tissue transglutaminase or anti-endomysial antibodies, then small bowel biopsy in antibody positive children122References American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S42. Holmes GK. Screening for coeliac disease in type 1 diabetes. Arch Dis Child 2002;87:495-498. Rewers M, Liu E, Simmons J, Redondo MJ, Hoffenberg EJ. Celiac disease associated with type 1 diabetes mellitus. Endocrinol Metab Clin North Am 2004;33:197–214, xi.