ESPE Abstracts

Introduction: Celiac disease (CD) and type 1 diabetes mellitus (T1DM) are autoimmune disorders that frequently coexist in pediatric patients, presenting a unique challenge in clinical management due to their overlapping nutritional deficiencies and potential for endocrine dysfunction. This study describes the clinical characteristics, the nutritional deficiencies and endocrine dysfunctions commonly observed in pediatric patients diagnosed with both CD and T1DM.

Key words: Child- diabetes- celiac- nutrition

Methods: This is a retrospective, descriptive study including 226 children hospitalized in the endocrinology-diabetology-nutrition department for the management of diabetes. All patients underwent a clinical examination and a biological work-up. The statistical analysis was performed with SPSS-version-21-software

Results: Mean age was 14 ± 3.5 years, sex ratio M/F was at 1,02. Mean HBA1C was at 10,87% ± 3.5%. 20,9 % of children had frequent unexplained hypoglycemia episodes. Autoimmune thyroid disease is present in 6,4% of patients, and Celiac disease (CD) in 3,7% of children with Type 1 diabetes. One-third of the patients diagnosed with CD, were symptomatic at the time of screening, while the majority was asymptomatic. The major clinical features indicative of CD were intestinal symptoms in 31.25 %, anemia in 25 % of patients, rickets in 18.75%, and short stature in 18.75 % of patients. Nutritional deficiencies were represented by iron deficiency in 30%, vitamin D deficiency in 26.4%, calcium deficiency in 76,1% and B12 vitamin deficiency in 5%.

Conclusion: The synergistic impact of CD and T1DM can exacerbate growth impairments and delay puberty, and also predisposes children to additional endocrine disorders such as autoimmune thyroiditis and adrenal insufficiency. Nutritional deficiencies, are frequent in pediatric patients with CD due to intestinal malabsorption. These deficiencies not only compromise nutritional status but also complicate glycemic control in patients with T1DM necessitating vigilant monitoring and supplementation.