Prevalence of coeliac disease in type I diabetes: a multicentre study

The aim of this study was to point out the prevalence ratio and the clinical presentation of coeliac disease (CD) in a large group of insulin-dependent diabetes mellitus (IDDM) patients. Patients and methods : 1114 patients affected by IDDM were screened for CD using antigliadin and antiendomysium antibodies. Patients who were positive for at least one test underwent an endoscopic biopsy of the descending duodenum in order to verify the presence of villous atrophy. Subjects with CD started a gluten-free diet and underwent a clinical follow-up. Results : Villous atrophy was found in 63 patients (5.6%). Among the Italian population, the rate was 7%. Twenty-four percent of coeliac patients presented with diarrhoea, while 22% were completely symptom-free. A significant correlation was found between the presence of villous atrophy and the duration and onset of diabetes. Conclusions : The prevalence of CD in IDDM is higher than previously reported, although the ratio range in different centres from 1.7 to 10%, probably due to both environmental and genetic factors. Twenty-two percent of coeliac patients were completely symptom-free. The prevalence seems to be significantly related to the duration and onset of IDDM.