Background: Children with type 1 diabetes mellitus (T1D) are at increased risk for celiac disease (CD) (4-6% prevalence) and ADA clinical practice guidelines recommend screening all children with T1D for CD annually. A prior study suggests that diagnosis with T1D under age nine years correlates with increased risk for CD.
Aim: Assess the risk of CD by patient age at T1D diagnosis.
Methods: We collected data, including TTG IgA serology and ICD9 codes for T1D and CD from the electronic medical records of patients diagnosed at a single pediatric hospital with T1D between January 1, 2009 and July 31 2017. An unadjusted Cox proportional hazards model was used to assess the risk of celiac disease in patients in two groups: those diagnosed with T1D <9 years of age and those diagnosed with T1D> 9 years of age. Subjects were censored at either: diagnosis with CD, last CD screen if lost-to-follow-up, or December 29, 2017. We determined CD diagnosis by ICD9 code.
Results: In the study period, 2263 patients were diagnosed with T1D with mean (SD) age at diagnosis 10.3 years (4.4). CD was diagnosed in 111 (5%). Mean age of T1D diagnosis for those who also developed CD was 8.6 years (4.5) and for those without CD was 10.3 years (4.3). In patients diagnosed with T1D <9 years 57 (6.7%) developed CD vs. 54 (4.7%) in >9 years. Within one year after T1D diagnosis 58 patients had been diagnosed with CD and the relative risk of CD in patients ≤ 9 years was 1.52 compared to patients > 9 years at T1DM diagnosis (95% CI 0.91, 2.54, p=0.111). Within 2 years of T1D diagnosis, 78 had been diagnosed with CD and the relative risk in patients ≤ 9 years was 1.83 vs. patients > 9 years at T1D diagnosis (95% CI 1.17, 2.86, p=0.008).
Conclusion: Patients <9 years at time of T1DM diagnosis have increased risk of CD within 2 years of initial T1D diagnosis compared to patients >9 years at T1D diagnosis.
E. Alving: None. K. Carlin: None. D. Lee: None. A.J. Roberts: None. J. Dickerson: None. I. Gorbounova: None. H. Law: None.
Seattle Children’s Hospital