Factors associated with adherence to gluten-free diet in patients with concomitant celiac disease and type 1 diabetes.

Celiac disease (CeD) and type 1 diabetes (T1D) often coexist. The burden of concomitant conditions may predispose CeD patients to impaired adherence to a gluten-free diet (GFD), but the factors predisposing to dietary lapses remain unclear. We compared the baseline characteristics and follow-up data between adherent and nonadherent CeD children with a dual diagnosis (n = 69). Overall, 72% were found to be adherent, while 28% were nonadherent. Adherent patients were detected significantly more often in annual CeD screening than by symptoms, whereas the groups did not differ in sex, familial risk for CeD or T1D, presence of other diseases, age at T1D and CeD diagnoses, or time between diagnoses, severity of clinical symptoms, or duodenal lesion at CeD diagnosis, or CeD autoantibody levels at diagnosis or during treatment. Dietary adherence is suboptimal in CeD patients with concomitant T1D, but a CeD diagnosis via systematic screening does not predispose to this.