Association Between Celiac Disease and Hemoglobin A1c Levels in Type 1 Diabetes Pediatric Patients - A Retrospective Chart Review

Document Type

Conference Proceeding

Publication Date

6-2025

Publication Title

Diabetes

Abstract

Introduction and Objective: Celiac disease (CD) and Type 1 Diabetes Mellitus (T1DM) often co-occur due to shared autoimmune mechanisms. While a gluten-free diet is the only treatment for CD, its impact on glycemic control and Hemoglobin A1c (HbA1c) remains unclear. This study examines the association between CD and uncontrolled HbA1c levels in a pediatric T1DM population. Methods: The study is a retrospective chart review of patients less than 18 years old with T1DM ICD-10 codes across Corewell Health East in metropolitan Detroit area spanning 01/01/2012 to 12/31/2023. We analyzed data from 2203 pediatric patients with T1DM, stratified by CD status (Yes: n=101; No: n=2,102) and glycemic control (Controlled HbA1c < 7: n=561; Uncontrolled HbA1c ≥7: n=1642). HbA1c values of less than 3.5 or greater than 20 were excluded. Statistical analysis included Chi-square, t-test, and logistic regression. Results: Of the 2203 pediatric patients with T1DM, 4.6% had concurrent CD diagnosis. The majority of the T1DM patients were male (54.2%), White (70.3%) with a median age of 12 [range 0-17]. T1DM patients with CD had a significantly higher number of HbA1c measurements (Mean [SD]: 16.90 [12.17] vs. 10.54 [9.93], p< 0.0001). In addition, a higher proportion of T1DM patients with CD had an average HbA1c ≥ 7 (uncontrolled) compared to those without (89.1% vs. 73.8%, p< 0.0006). Using regression analysis, T1DM patients with CD had significantly higher odds of having uncontrolled HbA1c levels (adj OR: 2.60, 95% CI: 1.37-4.90) after adjusting for age, race and gender. Conclusion: This study found that pediatric patients with both T1DM and CD had higher risk of uncontrolled DM. Also, T1DM patients with CD had more frequent HbA1c measurements, suggesting increased glycemic variability or challenges in control. These findings emphasize the need for close monitoring and individualized management for pediatric patients with both conditions.

Volume

74

Issue

Suppl 1

First Page

1197-P

Last Page

1197-P

Comments

American Diabetes Association 85th Annual Scientific Sessions, June 20-23, 2025, Chicago, IL

DOI

10.2337/db25-1197-P

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