P-117: Histological confirmation of asymptomatic celiac disease in type 1 diabetes enrolled in changing diabetic in children (CDiC) project in Multan, Pakistan
W I khan, E GhafoorAbstract
Introduction
Type 1 Diabetes Mellitus (T1DM) is a chronic multi systemic disease frequently co morbid with Celiac Disease (CD) due to shared autoimmune pathways. While routine screening is established, the clinical necessity for immediate histological confirmation in asymptomatic patients remains debated.
Objectives
This study evaluated whether the timing of histological confirmation (early vs. delayed) in tTG-IgA positive T1DM children impacts metabolic control, growth, or acute complication rates.
Methods
A retrospective analysis was conducted at the Children’s Hospital and Institute of Child Health, Multan (Jan 2022 – Dec 2025). Of 800 children screened via anti-tissue transglutaminase (tTG) IgA, 54 (6.8%) with titer >2X times the upper limit of normal (ULN) were enrolled. Patients were stratified by diagnostic timing: the Early Group (n=35), diagnosis <12 months) and the Late Group (n=19), diagnosis 12–36 months).
Results
Comparative analysis revealed no significant disparities between the Early and Late groups. Median diabetes duration was 3.8 vs. 3.4 years (P=1.00), and glycemic control was comparable with mean HbAc levels of 8.5% and 8.2%, respectively (P=0.58). Incidence of acute diabetic complications (DKA/hypoglycemia) and physical growth trajectories remained concordant across both cohorts. Furthermore, serological normalization (tTG-IgA) was achieved in 54% of the early group versus 51.5% in the late group (P=0.8).
Conclusions
In asymptomatic T1DM patients, delaying histological confirmation of Celiac Disease for several months does not yield adverse metabolic or clinical sequelae. These findings suggest that a monitored delay is a safe clinical pathway, potentially reducing immediate procedural burdens without compromising paediatric developmental outcomes.