The Implications of Type 1 Diabetes Mellitus Associated with Coeliac Disease

TL;DR

This review discusses the link between Type 1 Diabetes and Coeliac Disease, emphasizing the need for careful screening and patient-centered management.

Contribution

The paper highlights the importance of considering patient readiness and mental health in managing dual diagnoses of T1D and CD.

Findings

Coeliac Disease is over-represented in individuals with Type 1 Diabetes.

Screening for CD in T1D patients is recommended due to its treatable nature.

A monitoring approach may be better than immediate biopsy for some patients.

Abstract

T1D and CD commonly occur together. This association has received increasing attention from researchers and is considered in detail in this review. Since CD is over-represented in T1D, it may cause ill health with attendant complications, but because there is an effective dietary treatment, screening has been recommended in children and adults. However, there are many unknowns regarding this association, and understanding the why, when, and how with regard to screening and managing those with dual diagnoses requires thorough consideration when introducing the concept of screening to patients. It is important that patients and, where appropriate, carers are put at the heart of the decision-making process with careful discussion of the issues involved before undertaking screening that might uncover a second life-changing diagnosis, for which, without preparatory preparation and support, individuals may be ill-prepared, causing mental health issues. For some patients, an initial policy of monitoring rather than moving to immediate small bowel biopsy and exposure to a gluten-free diet (GFD) will be appropriate. The correct management of patients will ultimately improve their quality of life medically and socially.

Figures