Screening for coeliac disease in an adult cohort of patients with type 1 diabetes

Patients with type 1 diabetes have an increased prevalence of coeliac disease as compared with the general population due to common genotypes. Recent evidence has suggested that deregulation of gastrointestinal mucosal immunity may be essential to the development of both diseases. Currently, strong evidence supports the serological screening of paediatric patients with type 1 diabetes for coeliac disease. A key clinical question in the management of type 1 diabetes is whether adult patients should be routinely screened for coeliac disease. To investigate the use of coeliac screening in endocrine practice we retrospectively reviewed the records of 4,138 patients attending our diabetes centre over a four-year period and identified 572 patients with type 1 diabetes. We found that approximately one out of five patients with type 1 diabetes had been serologically screened for coeliac disease. The prevalence of coeliac disease at 1.69% in this adult cohort was lower than expected. This demonstrates that a significant proportion of adult patients with type 1 diabetes had been serologically screened for coeliac disease as part of routine care despite there being no clear indication to test.