Children with coeliac disease and insulin dependent diabetes mellitus - Growth, diabetes control and dietary intake

We aimed to assess the growth, diabetes control, dietary intake and complia nce with a gluten-free diet in children with insulin dependent diabetes mel litus (IDDM) and coeliac disease in a major paediatric and adolescent diabe tes clinic, Children with IDDM and biopsy-proven coeliac disease aged <18 y ears were included and compared with IDDM controls matched for age, sex and duration of diabetes. Twenty patients with coeliac disease and IDDM partic ipated (15 female, age 7.4-17.3 yr), with two matched IDDM controls for eac h (age 6.9-17.4 yr), The prevalence of coeliac disease in this diabetes cli nic population was 2.6%, All patients completed a 3 day food record (3DFR) and a 7 day food frequency questionnaire (FFQ) to assess dietary intake and gluten-free compliance. Diabetes control measured by HbA(1c) was not diffe rent between groups or compared to the overall clinic population (8.48 +/- 0.98% for coeliac patients vs 8.87 +/- 1.46 for IDDM controls vs 8.60 +/- 1 .30 for overall clinic population aged 5.0-17.9 yr), Height, weight and BMI standard deviation scores were not different between coeliac patients and IDDM controls, No clinically significant differences were found in intake o f energy, macronutrients or micronutrients. The proportion of energy intake from carbohydrate, protein and fat was within recommended ranges, except f or a higher saturated fat intake. Only 30% of coeliac patients complied wit h a strict gluten-free diet, but growth parameters were unaffected by dieta ry compliance. Thus, we found that children and adolescents with coexisting IDDM and coeliac disease have normal growth, equivalent diabetes control a nd no differences in energy or nutrient intake compared to matched IDDM con trols in our clinic population.