Celiac Disease in Type1 Diabetes: Prevalence, Pathogenesis and Clinical Implications

Shaima Basil Salman, Dhuha Badr Mahmood, Afraa Naje Jamel and Dhamyaa Obaid Shalgam

Abstract

Absolute insulin insufficiency and persistent hyperglycemia are symptoms of type 1 diabetes mellitus (T1DM), an autoimmune illness marked by the immune-mediated death of pancreatic β-cells. Shared genetic and immunological processes, especially involving HLA-DQ2 and DQ8 alleles, sometimes link type 1 diabetes (T1DM) with celiac disease (CD), another autoimmune condition that is induced by gluten consumption. Type 1 diabetes mellitus (T1DM) and chronic kidney disease (CD) occurring together constitute a subtype of autoimmune polyendocrine syndrome (APS-4), which makes metabolic regulation and therapeutic care more challenging. With variations depending on regional and dietary variables, the frequency of CD among T1DM patients is much greater (4-10%) than in the general population. It is essential to screen T1DM patients for CD since many individuals do not show symptoms or have unusual signs including growth retardation, anemia, or hypoglycemia. Adherence to a gluten-free diet (GFD) and prompt diagnosis greatly enhance metabolic parameters, development, and overall quality of life. The significance of routine screening, early diagnosis, and integrated treatment for best results is highlighted in this review that outlines the genetic, pathophysiological, and clinical intersections of type 1 diabetes and chronic kidney disease.