Maintaining the gluten-free diet: The key to improve glycemic metrics in youths with type 1 diabetes and celiac disease
Enza Mozzillo, Marco Marigliano, Irene Cuccurullo, Federica Berchielli, Renata Auricchio, Claudio Maffeis, Francesco Maria Rosanio, Dario Iafusco, Carlo Pedrolli, Riccardo Pertile, Maurizio Delvecchio, Stefano Passanisi, Giuseppina Salzano, Francesca Di Candia, Roberto Franceschi
Abstract
AIMS: Gluten-free diets (GFD) were considered as high glycemic index and/or high content of saturated fats; this could affect keeping good metabolic control in individuals with both type 1 diabetes (T1D) and celiac disease (CD). Our objective was to analyze time in range and other continuous glucose monitoring (CGM) metrics with real-time CGM systems, in youths with T1D and CD, compared to those with T1D only. METHODS: An observational case-control study, comparing youths aged 8-18 years with T1D and CD, with people with T1D only was performed. The degree of maintaining GFD was assessed through anti-tissue transglutaminase antibodies and dietary interview, and maintaining Mediterranean diet through the KIDMED questionnaire. RESULTS: 86 youths with T1D and CD, 167 controls with T1D only, were included in the study and the two groups reported similar real-time CGM metrics. Among the first group, 29 % were not completely maintaining GFD and compared to people with T1D only they showed higher hyperglycemia rates (% time above range: 38.72 ± 20.94 vs 34.34 ± 20.94; P = 0.039). CONCLUSIONS: Individuals with T1D and CD who maintain GFD presented similar glucose metrics compared to youths with T1D only. Individuals not strictly maintaining GFD presented higher hyperglycemia rates.