A 12-year-old girl with type 1 diabetes mellitus for 5 years presents for routine follow-up. Her HbA1c has risen from 7.2% to 8.1% over 6 months despite reported compliance. She reports occasional abdominal bloating and loose stools. According to current ISPAD guidelines, what is the recommended screening approach for celiac disease in children with type 1 diabetes?

• A Anti-tissue transglutaminase IgA at diagnosis only
• B Anti-endomysial antibodies at diagnosis and every 3 years thereafter
• C Anti-tissue transglutaminase IgA at diagnosis and every 5 years thereafter
• D Anti-tissue transglutaminase IgA at diagnosis and every 1-2 years thereafter ✓

Explanation

Children with type 1 diabetes have a 3-16% prevalence of celiac disease. ISPAD guidelines recommend screening with anti-tissue transglutaminase IgA (with total IgA to exclude deficiency) at diagnosis of T1DM and every 1-2 years thereafter, or if symptoms develop. Rising HbA1c and bloating may indicate malabsorption from celiac disease.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.