Background: Patients with type 1 diabetes mellitus (DM1) are at risk for having autoimmune conditions such as Celiac Disease (CD). Although uncommon, the presence of CD in a patient with DM1 may result in poor glycemic control, gastrointestinal complaints, nutritional deficiencies, osteoporosis and lymphoma. Recognizing CD is problematic as it is often asymptomatic or presents in an atypical fashion. Despite recommendations from both the ADA and the American College of Gastroenterology our experience suggests there is a general lack of recognition of screening recommendations and presentation in CD particularly in patients with DM1.

Methods: Our objectives were three-fold. We first developed a novel on-line assessment program to determine existing knowledge on CD in both medical and family practice residents and faculty. We then developed on-line and direct education to improve knowledge on screening, presentation and diagnosis of CD. Lastly, we have determined the screening rate of adults with a diagnosis of DM1.

Results: Our screening rate of at-risk adults with DM1 is less than 20% indicating a poor recognition of CD as a recognized risk. In addition, we determined that CD is rarely considered in patients with DM1 with poorly controlled diabetes even in the context of GI complaints. Our preliminary survey of residents’ knowledge on screening, diagnosis and complications of CD was poor with less than 35% having adequate knowledge status.

Conclusion: Screening for CD in our DM1 patients is poor due to lack of knowledge of criteria and screening strategy of providers. This may reflect a significant deficit in resident and faculty knowledge of CD. In addition, CD is rarely considered in symptomatic adults with DM1. We propose our education program aimed at both residents and our faculty will overcome our lack of an organized education program addressing CD and is predicted to improve screening, diagnosis and treatment of adults with DM1 suffering from CD within our population.

Disclosure

M. Epps: None. M. Fox: None. J. Jafari: None. A. Firek: None.

© 2019 by the American Diabetes Association.
2019
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