AACE2021-A-1087: Prevalence of Celiac Disease in Saudi Patients with Type 1 Diabetes Mellitus

Abstract

The objective of our study is to determine the prevalence of celiac disease (CD) in adolescents and adults with type 1 diabetes mellitus (T1DM) using anti-tissue transglutaminase (anti-tTG) antibodies and/or endoscope, This study is a chart review retrospective study involving all adolescents and adults with T1DM who were screened for CD at king Abdulaziz medical city Riyadh between 2010 and 2019. The sample size was calculated to be 537 patients based on estimated prevalence of 10% of celiac disease. The study sample wad randomly selected from all patients diagnosed with T1DM and who had CD screening test in the institution. The software SPSSv22 was used for the sample selection. The study variables include age, sex, age of diagnosis with T1DM, age of positive celiac screening, glycated hemoglobin HBA1c, total daily dose, diabetes ketoacidosis (DKA) frequency and other autoimmune diseases. Ethical approval was obtained by ethical board committee with study number: RC19/295/R. A total 539 patients’ records were reviewed. The prevalence of positive celiac screening in our sample is 11.5% ( 4.1% males and 7.4% females). CD prevalence based on positive screening test was equal (5.7%)in young patients (age groups 10-19 years) and older patients (age group 19-65 years). About 8% of positive CD patients in this study diagnosed with T1DM after documented positive celiac screening test. Moreover; around 16% of them developed T1DM and screened positive at the same year. The rest of the patients were found to have positive CD screening after they were diagnosed with T1DM. Regarding A1C, 69.35% of positive screened celiac patients had A1C level between 7-10%. The rest of the patients with positive CD screening had their A1C level of > 10 and represents around 24% and only 6.45% have A1C less than 7%. Around 51% of the patients with CD positive screening never had DKA. The amount of total daily dose was significantly lower in positive CD patients compared to negative CD patients. There was no statistical significant difference between patients with CD screening positive or negative regarding A1C, microvascular complication of diabetes or thyroid disorder. Regarding histopathological confirmation of CD; only 37% Of those screened positive underwent endoscopy; of which 43% were found to have normal endoscopic biopsy findings, 21.7% found to have partial villous atrophy and 34.7% were found to have total villous atrophy. This study highlighted the importance of screening for CD in T1DM patients. CD prevalence is significantly high in patients with T1DM despite the likelihood of under diagnosis of the problem. Additional Saudi studies with different age groups and methods are required. In addition, a unified national strategy to diagnose CD in T1DM patients is highly advisable.