There is a well-established association between type 1 diabetes mellitus (T1D) and celiac disease (CD) with CD conferring an increased risk of lower bone mineral density (BMD), depression, and overall mortality. The prevalence of CD in the general population is estimated at 1%, while the prevalence of CD in the T1D population has been estimated to be 2.4-16.4%. There are no CD screening guidelines for screening adult patients with T1D. We aimed to determine the prevalence and characteristics of T1D patients with and without CD, and screened and unscreened patients. We analyzed data from 1,001 people with T1DM from a large single center T1D population. Chart review confirmed CD status and screening with serum antibody or duodenal biopsy since 2010. The prevalence of CD was 4%. Of adults with T1D, 39% had evidence of serologic screening for CD, and 58% of diagnoses were found through screening since 2010. The average age of people with T1D and prevalent CD was 40.7 years, which was younger than unscreened patients (mean age 47.9 years, P<0.006). Unscreened patients had significantly higher BMI (mean BMI 27.5 kg/m2) than those who screened negative (mean BMI 26.2) (p<0.0001). Unscreened patients and those with CD had similar A1C, LDL, and microalbumin suggesting that it may be challenging to risk stratify by clinical characteristics, and that there may be undiagnosed CD in the unscreened population.


J. Sloane: None. B. Porneala: None. D.J. Wexler: Other Relationship; Spouse/Partner; APOLO1BIO.

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