Zuzana Michnová, Zuzana Havlíčeková, Jarmila Vojtková Stanislava Suroviaková, Marek Pršo, Peter Bánovčin
Background: Type 1 diabetes mellitus (DM1) is one of the most frequent and consequential chronic metabolic diseases
in children. The incidence of DM1 has rapidly grown during the 20th Century, its prevalence in general population
is approximately 2-3%. Owing to a common genetic background and interplay between environmental and immunological
factors, patients with DM1 are at high risk of developing other autoimmune disorders. The most freguent autoimmune
disorder diagnosed in DM1 patients after autoimmune thyroiditis is celiac disease (CD). The prevalence of CD
in DM1 varies from 3 to 16%. The clinical presentation of CD in DM1 is approximately in half of cases asymptomatic.
Aims:The aims of our study were to estimate the incidence of coeliac disease and investigate parameters of metabolic
control of the disease in group of adolescents with DM1.
Methods: We enrolled in the study 72 children with DM1 (29 boys, 40.27% and 43 girls, 59.72 %) who were hospitalized
in 2015 at the Department of Paediatrics, University Hospital in Martin to perform control testing, adjust insulin
therapy, or set an insulin pump for therapy.
All subjects underwent the panel of standard biochemical blood tests: fasting glucose level, fasting lipid profile, liver
enzymes, creatinine, total bilirubin, glycated hemoglobin, C-peptide, microalbuminuria, antibodies to tissue transglutaminase
IgA, IgG, total serum IgA and ultrasonographic examination of the abdomen.
Results: the median age was 13.42 years (IQR: 10.50-18.50 years). The average duration of diabetes in the population was
5.30 years (IQR: 1.80-8.30 years). Diabetes compensation was unsatisfactory, HbA1c was 10.19% (IQR: 6.50-16.40%).
Dyslipidaemia was present in 29 children, i.e. 40.28 %. Celiac disease occurred simultaneously in 9 children, i.e. 12.5 %.
By comparing parameters of metabolic control between the subgroups of patients with DM1 and celiac disease and patients
with DM1 without celiac disease we did not find a statistically significant difference between the two subgroups.
Conclusios: Serological screening for CD shoud be performed in all patients with DM1 by means of antibodies to tissue
trasglutaminase at DM1 onset, and then in regular time interval. Patients with DM1 found to be celiacs must be
treated by a gluten-free diet.