Endocrine Abstracts

Introduction and background: Diabetes Mellites is a complex metabolic disorder characterized by chronic hyperglycaemia. Celiac disease & T1DM are immune-mediated diseases that share common susceptibility factors notably HLA genetics. AITD and T1DM are two common autoimmune diseases that can occur concomitantly. It has been proposed that a complex genetic basis together with multiple nongenetic factors make a variable contribution to the pathogenesis of T1DM and AITD. NICE recommends T1DM patients are offered a test for coeliac disease & thyroid disease as they have a higher risk of the Coeliac disease and thyroid disease as compared to the general population. ACDC & KGH NHS Hospital’s guidelines recommend checking diabetes auto-antibodies.

Aims: The aim of this audit is to review the local practises and compare them with the guidelines as set out by NICE & ACDC.

Methodology: Data collected for the period of 1st of April 2021 till June 2022. 30 patients studied in this cohort. Ethical approval granted. Data collected using twinkle, Careflow connect and mediviewer

Findings: 17 F:13M Initial Coeliac Disease screen done in 97% participants In 2 patients CD screen positive, 1 insufficient sample. 97% of the patients had TFTs done at the time of T1DM diagnosis. None of the cohort tested for TFTs had abnormal TFTs. 94% of patients had T1DM Auto-antibodies checked. 87% of the patients diagnosed with T1DM came back as auto-antibodies positive, while in 2 patients auto antibodies are negative, while 2 had insufficient sample.

Conclusions: 97% compliance noted in terms of checking for Coeliac disease, 6% of cohort’s CD screen came back as positive. 97% compliance noted for checking TFTs. 94% of patients had T1DM Auto-antibodies checked 87% of the patients were auto-antibodies positive. Checking T1DM auto-antibodies should be part of NICE recommendations to help clinicians understand the T1DM and optimise patient care.

Reference: Cohn A, Sofia AM, Kupfer SS. Type 1 diabetes and celiac disease: clinical overlap and new insights into disease pathogenesis. Curr Diab Rep. 2014;14(8): 517. doi:10.1007/s11892-014-0517-x