This study, as part of the screening phase of the large, multicentre CD-DIET (Celiac Disease and Diabetes – Dietary Intervention and Evaluation Trial) study, sought to compare rates of gastrointestinal (GI) symptoms between paediatric and adult patients with type 1 diabetes. A total of 1002 young people and 1368 adults were surveyed using the validated GI Symptom Scale questionnaire.
Among the overall cohort (N=2370), 17.1% reported having one GI symptom, 8.4% had two, and 3.5% had three or more. Adults were more likely to report GI symptoms than young people (34.1% vs 21.7%; odds ratio [OR], 1.87). Female participants were also more likely to have symptoms than males (37.1% vs 20.8%; OR, 2.25), and this finding was consistent across age groups.
The most common symptoms in children and young people were upper and lower abdominal pain, with rates of 8.6% and 8.4%, respectively. In adults the symptoms most often involved the lower GI tract, and included loose stools (13.8%), hard stools (8.5%) and lower abdominal pain (12.6%).
Participants were 1.4 times as likely to have GI symptoms if they had a documented diabetes complication; after adjustment for age and sex, retinopathy (OR, 1.65) and neuropathy (OR, 3.14) were significantly associated with GI symptoms. Higher HbA1c was associated with GI symptoms, with each 10 mmol/mol increase associated with an 8.1% increase in the odds of reporting one or more symptoms, after adjustment for age and sex.
The authors conclude that GI symptoms are common in people with type 1 diabetes and that the type of symptoms varies on the basis of age. Attention should be given to GI symptoms and their relationship with HbA1c and microvascular complications.
Vinod Patel highlights the growing evidence base that lifestyle interventions are effective, and encourages persistence even though they can be difficult.
25 May 2023