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Incidence and Associated Risk Factors of Coeliac Disease in Children Newly Diagnosed With Type 1 Diabetes: A 5‐Year Nationwide Prospective Study From Kuwait

Year: 2026

Type: article

Abstract: AIMS: Kuwait has one of the highest global incidences of childhood type 1 diabetes (T1D), yet little is known about the burden of coeliac disease (CD) in this population. We aimed to determine the prevalence/incidence of CD in children newly diagnosed with T1D in Kuwait and identify associated risk factors. METHODS: In this prospective cohort study, all 1938 children (≤ 14 years) diagnosed with T1D in Kuwait between 2011 and 2017 were enrolled and followed for 5 years post-diagnosis. CD development was defined by intestinal biopsy confirmation. Cox univariable regression models quantified associations between several characteristics at T1D diagnosis (age, sex, DKA, height z-score and BMI z-score) and incident CD risk. RESULTS: Four baseline CD cases were excluded. Of the remaining 1934 children, 65 (3.4%) developed CD during follow-up. The median time to CD diagnosis was 1.5 years; 40% were diagnosed within the first year. The incidence rate within the first year following T1D diagnosis was 1.35 (95% CI 0.92-1.99) per 100 person-years and generally declined over subsequent years of follow-up. While age at diagnosis showed no clear effect shortly after T1D diagnosis, older age was associated with progressively lower CD risk over longer follow-up, with the risk of CD being 33% lower per one-year increase in age at diagnosis by 5 years of follow-up; no other baseline factors investigated were significant. CONCLUSION: This nationwide prospective study highlights the burden and timing of biopsy-confirmed CD after T1D onset. CD occurred most frequently during the early years after T1D diagnosis, with a higher risk among younger children, supporting particular attention to screening in these groups.

Source: Diabetes/Metabolism Research and Reviews

DOI: 10.1002/dmrr.70246