Abstract
Type 1 diabetes mellitus (T1DM) and celiac disease (CD) are one of the most recognized related autoimmune disorders as they share a common genetic background that has been found in the HLA genotype, more specifically DQ2 and DQ8 molecules. Studies have shown that environmental factors as early or late exposure to cereals in the first months of life or the acquired viral infections have been implicated in the risk of development of autoantigens. CD, in most cases, is asymptomatic; therefore, it goes underdiagnosed. As a result, it has been linked to late consequences as decreased growth, delayed puberty, and anemia. Also, CD has been considered an independent risk factor for nephropathy and retinopathy. Therefore, in T1DM patients, as high-risk individuals, a CD screening has been recommended, especially to analyze their joint management. A gluten-free diet has been studied and linked to possible benefits in glycemic control or decreasing the hypoglycemic episodes in T1DM and preventing in CD the late bowel mucosal damage as gluten has been well documented as the primary trigger of these autoimmune responses. This article has reviewed the concurrent occurrence of T1DM and CD regarding the pathogenesis, clinical overlaps, screening, and management options.
Highlights
Type 1 diabetes mellitus (T1DM) and celiac disease (CD) are one of the most recognized related autoimmune disorders as they share a common genetic background that has been found in the HLA genotype, DQ2 and DQ8 molecules
In patients with CD, DQ2 was found in 85.7%, DQ8 in 11.4%, and DQ2/DQ8 at the same time in 2.8%
In patients with concurrent CD and T1DM, DQ2 was found in 31.4%, CD8 25%, and DQ2/DQ8 34%, and just nine of these individuals were experiencing CD [20]
Summary
Type 1 diabetes mellitus (T1DM) is an autoimmune disorder (AD) characterized by pancreatic beta cell destruction in the islets of Langerhans caused by autoantibodies. The Diabetes Autoimmunity Study in the Young DAYSI has been continuously studying the causes and risks factors of type 1 diabetes In one of their investigations, Frederiksen B. et al reported a period between four and six months of age to introduce cereals without increasing the risks to present islet autoimmunity (IA). The Environmental Determinants of Diabetes in the Young (TEDDY) study, a large prospective cohort study of the environmental factors as risks factors for T1DM, during 20042009, enrolled 8,676 individuals at three months of age into a 15-year follow-up study One of their studies, which included 8,676 children, determined the association of respiratory infections and the subsequent risk of developing islet autoantibodies.
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