Diabete e celiachia

The association of autoimmune type 1 diabetes mellitus and celiac disease in children and adolescents has been known for a long time. This critical review of the literature should encourage readers to reassess many of the recent concepts on celiac disease screening accepted for the general population but that must be carefully evaluated before they are passively applied in high-risk pediatric populations predisposed to autoimmune diseases. The high frequency of potential celiac disease in diabetic patients, for example, implies the need for duodenal biopsy to establish a precise diagnosis. The diagnosis of celiac disease in a child or a teenager with diabetes mellitus may have negative effects on compliance with therapy and metabolic control. Then too, the introduction of glutenfree foods, for example, giving a high intake of rapidly absorbed carbohydrates, may make it necessary to increase the insulin dose.