Prevalence of celiac disease among Type 1 diabetes mellitus in Diabetic center of Tabuk City, Saudi Arabia 2024: a cross sectional retrospective medical record-based study

Background: Celiac disease (CD) is an autoimmune enteropathy triggered by gluten ingestion in genetically susceptible individuals. It is frequently associated with other autoimmune conditions, particularly type 1 diabetes mellitus (T1DM). Early identification of CD in T1DM patients is essential to prevent complications and improve outcomes. Objective: To determine the prevalence of celiac disease among patients with T1DM at the Diabetic Center in Tabuk City, Saudi Arabia, and to identify associated risk factors, common symptoms, and diagnostic patterns. Methods: A cross-sectional, retrospective study was conducted based on medical records of 373 patients with T1DM attending the Diabetic Center of King Fahad Hospital in Tabuk City between May and August 2024. Data were collected using a structured and validated form covering demographic, clinical, and diagnostic details. Statistical analysis was performed using SPSS version 18, with descriptive statistics and inferential tests including Fisher’s Exact Test, t-tests, and ANOVA. A p-value < 0.05 was considered statistically significant. Results: The prevalence of diagnosed celiac disease among T1DM patients was 2.4% (n=9). All cases were diagnosed using anti-tTG antibodies, and common presenting symptoms included abdominal pain (44.4%) and diarrhea (33.3%). A significant association was found between CD and being underweight (p = 0.049). Other variables such as age, gender, insulin dosage, and DKA frequency showed no significant correlation with CD. However, males and patients diagnosed with T1DM at an older age were found to have a significantly later diagnosis of CD (p = 0.001). Conclusion: Celiac disease is relatively uncommon but clinically relevant among T1DM patients in Tabuk City. Underweight status may serve as a useful clinical indicator for CD screening. Given the variable presentation of CD, universal screening in T1DM patients remains important for early diagnosis and management. Keywords Celiac disease, Type 1 diabetes mellitus, Prevalence, Risk factors, Saudi Arabia, Gluten, Anti-tTG antibodies.