Is Routine Screening for Type 1 Diabetes and Thyroid Disease Necessary?
The considerable overlap between celiac disease and type 1 diabetes (T1D) is well known; the same can be said of celiac disease and autoimmune thyroid disease (ATD). The question remains, do individuals (notably, children) with celiac disease need to be routinely screened for development of these other conditions?
A recently published article in the Journal of Pediatrics titled, “Time to Screen Children with Celiac Disease for Thyroid Disease?” brought together the results of several similar studies on this topic in an attempt to pinpoint the effectiveness and necessity of routine monitoring for T1D and ATD in patients already diagnosed with celiac disease.
First and foremost, there is a higher risk for both conditions (as well as other autoimmune disorders) in individuals who do not adhere to the gluten-free diet. It seems that this treatment does offer some protective effect for those who are strict in their compliance.
With regard to those who follow treatment, while there is certainly at least some elevated risk of developing either T1D or ATD, the elapsed time between diagnoses can vary widely and is difficult to measure; the cost-benefit of routine screening only to catch a diagnosis as much as a decade later has yet to be investigated in detail. The reviewed studies concluded that routine screening for thyroid dysfunction is warranted more than routine screening for diabetes.
Co-author of the article, Norelle Reilly, MD, notes that “ongoing complications in someone with celiac disease can go unrecognized if they are not on our radar. The path to surveillance for kids with celiac disease is not always carved out or agreed upon.” Signs and symptoms of T1D are much harder to miss during regular care, making screening seem redundant. Conversely, the subtler nature of ATD symptoms is an argument in favor of screening; early detection of thyroid dysfunction allows for quicker and more effective treatment. Ritu Verma, MBChB, co-author of the article, explains that “there is so much work that needs to be done to look at other autoimmune diseases associated with celiac disease, but we don’t have the proper screening tools.” This begs the question: what other autoimmune diseases should we be paying attention to? Future research will need to look at how we can prevent other conditions from being developed.
Read more at https://celiac.org/blog/2016/10/is-routine-screening-for-type-1-diabetes-and-thyroid-disease-necessary/#lR0F1cZFBjyaChbh.99