CELIAC DISEASE IN PATIENTS WITH TYPE 1 DIABETES MELLITUS: IMPORTANCE OF EARLY SCREENING AND CLINICAL IMPACT

Resumo

Introduction: Type 1 Diabetes Mellitus (T1DM) is an autoimmune disease frequently associated with other immune-mediated disorders, especially Celiac Disease (CD). The prevalence of CD in pediatric patients with T1DM is significantly higher than in the general population, mainly due to shared genetic susceptibility related to HLA -DQ2 and HLA -DQ8 haplotypes. Most patients are asymptomatic or present nonspecific manifestations, making early screening essential to prevent long-term complications. Objective: To review the scientific literature regarding the association between Type 1 Diabetes Mellitus and Celiac Disease in pediatric p atients, emphasizing the importance of early screening and its clinical impact. Methods: This is a narrative literature review conducted using articles indexed in PubMed, SciELO, and LILACS databases. The descriptors “Type 1 Diabetes Mellitus”, “Celiac Dis ease”, “Children”, “Pediatrics”, and “Autoimmune Diseases” were used. Clinical studies, review articles, and current guidelines addressing screening, diagnosis, and clinical management of CD in pediatric patients with T1DM were included. Results: The prevalence of CD in patients with T1DM ranges from 1.6% to 16.4%, which is considerably higher than in the general population. Most pediatric patients present silent or subclinical forms of the disease, reinforcing the importance of systematic screening. Curren t guidelines recommend screening at the diagnosis of T1DM and periodic reassessment, especially during the first years after diagnosis. Serological evaluation with anti-tissue transglutaminase IgA antibodies associated with total IgA measurement remains th e preferred screening method. Early diagnosis and gluten - free diet adherence contribute to improved nutritional status, growth, and prevention of complications such as osteoporosis and delayed puberty. However, it doesn’t contribute to improved glycemic co ntrol. Conclusion: Early screening for Celiac Disease in pediatric patients with Type 1 Diabetes Mellitus is fundamental due to the high prevalence of asymptomatic cases and the potential clinical repercussions of delayed diagnosis. Multidisciplinary follo w-up and continuous monitoring are essential to improve quality of life and clinical outcomes in this population.