A Shared Path: Co-occurrence and Clinical Implications of Celiac Disease and Type 1 Diabetes Mellitus
DOI:
https://doi.org/10.12775/QS.2024.37.57099Keywords
celiac, CeD, T1DM, diabetes, glutenAbstract
Introduction:
Celiac disease (CeD) and Type 1 diabetes mellitus (T1DM) are autoimmune diseases that sometimes co-occur in genetically predisposed people. Both diseases share common genetic factors, such as human leukocyte antigens: HLA-DQ2 and HLA-DQ8. Apart from that, they share environmental factors such as gluten exposure, viral infections, and alterations in gut microbiota composition. CeD is a gluten-induced disease resulting in inflammation and impaired absorption of the nutrients, leading to malnutrition. In T1DM, β-cells in the pancreatic tissue are destroyed during the T-cell mediated reaction, which leads to impaired insulin production and development of insulin deficiency which leads to hyperglycemia and chronic complications.
Materials and methods:
This study is based on a review of multiple articles and prospective studies we managed to find online in the PubMed database.
Aim of the study:
The aim of the study is to investigate the clinical implications of T1DM and CeD, focusing on the importance of early screening for CeD in patients with T1DM and evaluate the challenges in the management of both diseases simultaneously. Additionally, the study highlights the potential benefits of a personalized approach to treatment.
Conclusions:
The co-occurrence of CeD and T1DM is common and it’s determined by shared genetic, immune, and environmental factors. Early screening and diagnosis are very important regarding the management strategies for these conditions. Gluten free diet (GFD) is the main treatment for CeD, but its adherence may be challenging, especially in T1DM patients who already face many restrictions on a daily basis. Personalized treatment approaches seem to be essential for simultaneously managing and optimizing CeD and T1DM. However, the lower compliance to GFD among T1DM patients suggests the need for further research to provide support for long-term management of both T1DM and CeD.
References
Therrien A, Kelly CP, Silvester JA. Celiac Disease: Extraintestinal Manifestations and Associated Conditions. J Clin Gastroenterol. 2020;54(1):8-21. doi:10.1097/MCG.0000000000001267
Aljada B, Zohni A, El-Matary W. The Gluten-Free Diet for Celiac Disease and Beyond. Nutrients. 2021;13(11):3993. Published 2021 Nov 9. doi:10.3390/nu13113993
Besser HA, Khosla C. Celiac disease: mechanisms and emerging therapeutics. Trends Pharmacol Sci. 2023;44(12):949-962. doi:10.1016/j.tips.2023.09.006
Ben Houmich T, Admou B. Celiac disease: Understandings in diagnostic, nutritional, and medicinal aspects. Int J Immunopathol Pharmacol. 2021;35:20587384211008709. doi:10.1177/20587384211008709
Liu Z, Wang H, Yang Z, Lu Y, Zou C. Causal associations between type 1 diabetes mellitus and cardiovascular diseases: a Mendelian randomization study. Cardiovasc Diabetol. 2023;22(1):236. Published 2023 Sep 2. doi:10.1186/s12933-023-01974-6
Akil AA, Yassin E, Al-Maraghi A, Aliyev E, Al-Malki K, Fakhro KA. Diagnosis and treatment of type 1 diabetes at the dawn of the personalized medicine era. J Transl Med. 2021;19(1):137. Published 2021 Apr 1. doi:10.1186/s12967-021-02778-6
Alsolaimani N, Kattan M, Algabbani Z, Awlia G, Alhamdani Y, AlAgha A. Comparison of pediatric diabetic ketoacidosis in newly diagnosed versus known patients with type 1 diabetes mellitus: A single-center study. Saudi Med J. 2024;45(12):1326-1333. doi:10.15537/smj.2024.45.12.20240734
Baloch SH, Ibrahim PMN, Lohano PD, Gowa MA, Mahar S, Memon R. Pediatric Risk of Mortality III Score in Predicting Mortality Among Diabetic Ketoacidosis Patients in a Pediatric Intensive Care Unit. Cureus. 2021;13(11):e19734. Published 2021 Nov 19. doi:10.7759/cureus.19734
American Diabetes Association. 3. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S28-S37. doi:10.2337/dc18-S003
Flores Monar GV, Islam H, Puttagunta SM, et al. Association Between Type 1 Diabetes Mellitus and Celiac Disease: Autoimmune Disorders With a Shared Genetic Background. Cureus. 2022;14(3):e22912. Published 2022 Mar 7. doi:10.7759/cureus.22912
Arora S, Tayade A, Bhardwaj T, Pathak SS. Unveiling the Link: A Comprehensive Narrative Review of the Relationship Between Type 1 Diabetes Mellitus and Celiac Disease. Cureus. 2023;15(10):e47726. Published 2023 Oct 26. doi:10.7759/cureus.47726
Prieto J, Singh KB, Nnadozie MC, et al. New Evidence in the Pathogenesis of Celiac Disease and Type 1 Diabetes Mellitus: A Systematic Review. Cureus. 2021;13(7):e16721. Published 2021 Jul 29. doi:10.7759/cureus.16721
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
Skoracka K, Hryhorowicz S, Rychter AM, et al. Why are western diet and western lifestyle pro-inflammatory risk factors of celiac disease?. Front Nutr. 2023;9:1054089. Published 2023 Jan 20. doi:10.3389/fnut.2022.1054089
Kemppainen KM, Lynch KF, Liu E, et al. Factors That Increase Risk of Celiac Disease Autoimmunity After a Gastrointestinal Infection in Early Life. Clin Gastroenterol Hepatol. 2017;15(5):694-702.e5. doi:10.1016/j.cgh.2016.10.033
Zajec A, Trebušak Podkrajšek K, Tesovnik T, et al. Pathogenesis of Type 1 Diabetes: Established Facts and New Insights. Genes (Basel). 2022;13(4):706. Published 2022 Apr 16. doi:10.3390/genes13040706
DiMeglio LA, Evans-Molina C, Oram RA. Type 1 diabetes. Lancet. 2018;391(10138):2449-2462. doi:10.1016/S0140-6736(18)31320-5
Antvorskov JC, Halldorsson TI, Josefsen K, et al. Association between maternal gluten intake and type 1 diabetes in offspring: national prospective cohort study in Denmark. BMJ. 2018;362:k3547. Published 2018 Sep 19. doi:10.1136/bmj.k3547
Singh P, Singh AD, Ahuja V, Makharia GK. Who to screen and how to screen for celiac disease. World J Gastroenterol. 2022;28(32):4493-4507. doi:10.3748/wjg.v28.i32.4493
Camarca ME, Mozzillo E, Nugnes R, et al. Celiac disease in type 1 diabetes mellitus. Ital J Pediatr. 2012;38:10. Published 2012 Mar 26. doi:10.1186/1824-7288-38-10
Villanacci V, Vanoli A, Leoncini G, et al. Celiac disease: histology-differential diagnosis-complications. A practical approach. Pathologica. 2020;112(3):186-196. doi:10.32074/1591-951X-157
Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA; American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108(5):656-677. doi:10.1038/ajg.2013.79
Eland I, Klieverik L, Mansour AA, Al-Toma A. Gluten-Free Diet in Co-Existent Celiac Disease and Type 1 Diabetes Mellitus: Is It Detrimental or Beneficial to Glycemic Control, Vascular Complications, and Quality of Life?. Nutrients. 2022;15(1):199. Published 2022 Dec 30. doi:10.3390/nu15010199
Popoviciu MS, Kaka N, Sethi Y, Patel N, Chopra H, Cavalu S. Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine. J Pers Med. 2023;13(3):422. Published 2023 Feb 26. doi:10.3390/jpm13030422
Díaz-Peña R. Personalized Medicine in Autoimmune Diseases. J Pers Med. 2021;11(11):1181. Published 2021 Nov 11. doi:10.3390/jpm11111181
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Wojciech Florczak, Joanna Śnieżna, Jakub Dziewic, Karol Dzwonnik, Wiktoria Domino, Urszula Zelik, Gabriela Trestka, Maria Przygoda, Jagienka Włodyka, Kamila Stępień, Sabina Adamczyk
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 165
Number of citations: 0
