World Journal of
Pharmaceutical and Life Sciences

CELIAC DISEASE IN CHILDREN AND ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS: PREVALENCE, TIME TO DIAGNOSIS, AND METABOLIC CHARACTERISTICS IN A TERTIARY CARE CENTER

*Samiha Kitani, Houda Bella, Hind Lachraf, Asmaa Mdaghri Alaoui, Zineb Imane

ABSTRACT

Background: Celiac disease (CD) is one of the most common autoimmune disorders associated with type 1 diabetes mellitus (T1D). Owing to shared genetic susceptibility and immunological mechanisms, children with T1D are at increased risk of developing CD. Early identification is essential to prevent long-term complications and optimize metabolic outcomes. Objective: To determine the prevalence of celiac disease among children and adolescents with type 1 diabetes mellitus and to describe the metabolic characteristics of patients with coexisting celiac disease and type 1 diabetes mellitus. Methods: A retrospective descriptive and analytical study was conducted at a tertiary pediatric referral center specializing in endocrinology and diabetology. Medical records of patients with T1D followed between January 2015 and December 2024 were reviewed. Screening for CD was systematically performed using anti-tissue transglutaminase IgA antibodies and total serum IgA levels, with histological confirmation by duodenal biopsy in positive cases. Glycemic control was assessed using glycated hemoglobin (HbA1c). Results:A total of 1,728 children and adolescents with T1D were included. Celiac disease was diagnosed in 71 patients, corresponding to a prevalence of 4.1%. CD was the most frequent autoimmune comorbidity identified in the study population. The mean age at diagnosis of CD was 8.7 years. Most cases (77.5%) were diagnosed within the first five years following T1D onset. Assessment of glycemic control showed that only 14.1% of patients achieved the recommended HbA1c target (≤7.0%), whereas 52.1% had HbA1c levels between 7% and 9%, and 33.8% had HbA1c levels >9%. Conclusions: Celiac disease is a frequent autoimmune comorbidity among children and adolescents with T1D. The majority of cases occur during the first years following diabetes onset, supporting the relevance of systematic screening in children and adolescents with T1D. The high proportion of patients with suboptimal glycemic control underscores the importance of early diagnosis and multidisciplinary management to optimize long-term outcomes.

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