Insulin-dependent diabetes and coeliac disease

Cornelius C Cronin, Fergus Shanahan

The prelavence is higher among patient with IDDM, with rates 1.0-7.8%. .... There should be a high index of suspicion of coealiac disease in all IDDM patients. IDDM patients with any gastrointestinal symtoms - no matter how mild or nonspecific - evidence of malabsorption, or unexplained constitutional symtoms should be investigated for coealiac disease. Patients in whom diagnosis is confirmed should be strongly advised to adhere to a gluten-free diet throughout life. However, even an increase in the awareness of this diagnosis will not lead to detection of all cases.

Should all IDDM patients, irrespective of symtoms, be screened bytest for IGA endomysial antibodies, the preferred screening test? ... We this disorder should be actively sought in all IDDM patients. ... Whether the benefits that accrue from this recommendation will balance the use of resources and difficulties many IDDM patients w this additional diagnosis will experience, can be ascertained only by controlled clinical trials.

The Lancet
vol 349 April 12 1997 p.1096-97