Endocrine Abstracts

Patients, especially children, with type 1 diabetes (T1D) have an increased risk of developing other autoimmune disorders including coeliac disease (CD). While the general population prevalence of CD is ~1%, in patients with T1DM the prevalence of CD is higher (0.6–16%). Gluten free diet (GFD) imposes limitations in dietary options. Many of the gluten-free foods have a high glycemic index. This can influence glycemic values and metabolic parameters. We selected the subgroup of pts with T1D attending our service between June 2011 and June 2013 who have concomitant CD (n=30). To determine whether differences exist in their metabolic parameters compared to those of the total cohort of patients with T1D attending our service in the same time-period (n=905), we did a cross-sectional analysis of clinic measurements of weight, BMI, BP, HbA1c, lipid profiles, albumin creatinine ratios, and tissue transglutamine IgG antibody titres (TTG) (as a marker of adherence to a GFD). The CD+T1D group consisted of 18 (60%) females and 25 (83%) adults (>18 years) and had a mean age of 37 (S.D. 19). The T1D group consisted of 431 (48%) females and 798 (88%) adults (>18 years) and had a mean age of 37 (17). HbA1c in the CD+T1D group was 76.4 mmol/mol (S.D. 17.4) vs 70.3 (17.7) in the T1D group (P=0.04). Children overall had higher HbA1c values (83.6 and 75.7, P<0.05). In the CD+T1D group, lipid profiles showed lower total cholesterol (4.0 vs 4.6), LDL cholesterol (2.0 vs 2.4), triglycerides (1.0 vs 1.3), and higher HDL cholesterol (2.0 vs 1.7) mmol/l levels than the T1D group (P<0.003). There was no significant difference in the proportion taking cholesterol lowering drugs (35% vs 31%). The CD+T1D group had a lower average BMI (24.0 vs 26.4, P<0.004). CD+T1D presents a challenge to achieving target HbA1c but confers some benefits for lipid profiles.