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.