CELIAC-DISEASE AND DIABETES-MELLITUS - A STUDY OF 24 PATIENTS WITH HLA TYPING

Abstract

The clinical features of 24 patients with celiac disease and insulin-dependent diabetes mellitus were reviewed. The HLA types of 17 of these patients were compared with those of 44 normal subjects, 49 patients with diabetes only and 58 patients with celiac disease only. The diagnosis of celiac disease was made after the diagnosis of diabetes in 14 patients, before diabetes in 5 and simultaneously in 5. In established diabetics, celiac disease was recognized relatively late (mean age 31 yr), but the average duration of symptoms attributable to celiac disease prior to a jejunal biopsy was 5 mo. Gluten restriction was generally followed by a marked improvement in diabetic control. The frequency of HLA-DR3 in patients with celiac disease and diabetes mellitus (88%), in patients with celiac disease only (88%) and in patients with insulin-dependent diabetes mellitus only (69%) was significantly greater than in normal subjects (44%). The subtype of diabetes related to DR4/B15 does not appear to predispose to celiac disease. The mechanism of the association between celiac disease and insulin-dependent diabetes is discussed and the importance of celiac disease in the differential diagnosis of diabetic diarrhea is emphasized.