502-P: Introduction of a Gluten-Free Diet in Children with Type 1 Diabetes and Coeliac Disease Did Not Impact Glycemic Control, Nutrient Intake, or Quality of Life at Three Months

Abstract

Studies on how a gluten free (GF) diet in youth with T1D and CD impacts glycemic control, quality of life (QoL) and nutrient intake are limited. The study aim was to determine the effects of the introduction of a GF diet in children with T1D and newly diagnosed CD on glycemic control, nutrient intake, QoL and body mass index (BMI). Subjects wore a continuous glucose monitor for 12 days and completed a 4-day food record at baseline and 3 months after implementing a GF diet. Participants and one parent completed the PedsQL questionnaire at baseline and 3 months. Ten children participated (age 10.8y ± 3.3, 40% male, BMI Z-score 0.5 ± 0.6, diabetes duration 2.2y ± 2.6 (50% with diabetes duration of <12 months), 60% on multiple daily injections, 20% on insulin pump therapy and 20% on twice-daily injections, HbA1c 6.0 ± 1.1%). BMI Z-score (0.4 vs. 0.5, p=0.73), glycemic variability % CV (40.4% vs. 40.2%, p=0.94), HbA1c (6.0% vs. 5.8%, p=0.56), percentage glucose time above target range >180mg/dL (30.3% vs. 36.1%, p=0.09) and below target range <70mg/dL (7.2% vs. 7.9%, p=0.76) did not change significantly from baseline to 3-months, however time in range (TIR) 70-180mg/dL (62.6% vs. 56.0%, p=0.02) was significantly lower at 3 months. Intake of fibre (18g vs. 16g, p=0.40), iron (9g vs. 8g, p=0.35), calcium (826mg vs. 791mg, p=0.75) and saturated fat (13.5% vs. 14.0%, p=0.77) were not significantly different from baseline to 3 months. QoL score was not significantly different for parents (63.2 vs. 67.4, p=0.08) or children (56.8 vs. 63.5, p=0.08) from baseline to 3 months. This study suggests that implementation of a GF diet in children with T1D does not adversely impact glycemic control, nutrient intake, QoL or BMI Z-score. The only change in glycemic control reduced TIR at 3 months which may represent changing insulin requirements with gut healing and the end of the remission phase of T1D. Disclosure A. L. Marlow: None. B. R. King: None. S. E. Johnson: Consultant; Self; Medtronic. S. K. Binkowski: None. J. Fairchild: None. E. A. Davis: None. C. E. Smart: None. Funding Australasian Paediatric Endocrine Group; Pfizer Inc. (WI205278)