Association of celiac disease with type 1 diabetes: A cross-sectional analysis in 2022

Background: Type 1 diabetes mellitus (T1DM) and celiac disease (CD) are autoimmune disorders with a common genetic basis. Celiac disease often presents asymptomatically, leading to delayed diagnosis and potential complications like anemia and growth delays. This research investigates the prevalence of celiac disease in T1DM patients at the Yazd Diabetes Center in 2022. Methods: This cross-sectional study, uniquely designed and executed, involved 318 T1DM patients sampled via census. Levels of IgA anti-tissue transglutaminase (TTG) antibodies and serum IgA were measured, with individuals having TTG-IgA levels over 10 U/mL undergoing endoscopy and duodenal biopsy. The data were meticulously analyzed using SPSS V.22, with significance at a p-value < 0.05. Results: Among the 318 patients, 25 (7.86%), comprising 15 (60%) females and 10(40%) males, underwent endoscopy and biopsy due to elevated TTG-IgA levels. Histopathological analysis revealed four (16%) patients with normal findings: 2 (8%) with Marsh type 1, 1 (4%) with Marsh type 2, and 18 (72%) with Marsh type 3. Patients with TTG levels exceeding 100 were all classified as Marsh type 3. Gender-wise, there was no significant difference in celiac disease type distribution. (P- value= 0.58) Conclusion: This study's findings, which reveal a celiac disease prevalence in T1DM patients similar to global rates, have significant implications for clinical practice. The importance of routine celiac disease screening for these patients is underscored, as is the urgent need for extensive multi-center studies to deepen our understanding of this relationship and improve patient care.