Gluten-Free Diet In Children With Recent-Onset Type 1 Diabetes Without Coeliac Disease: A 12-Month Intervention Trial

Objectives: Data on the role of gluten in type 1 diabetes (T1D) are scarce. We aimed to test whether gluten-free diet (GFD) can decelerate the decline in beta-cell capacity in newly diagnosed non-celiac T1D children. Methods: Forty-six children (aged 10.2±3.3 years) were recruited into this non-randomized self-selected intervention trial: 26 started with GFD whereas 20 remained on standard diet. Main outcomes were the decline in C-peptide area under the curve (AUC) in mixed-meal tolerance tests and the differences in insulin dose, insulin dose adjusted A1c (IDAA1c) and HbA1c at 12 months. Data were analyzed as intention-to-treat by linear regression models adjusted for baseline parameters. The adherence to GFD was tested by immunoreactive gluten in stool. Results: Mean decrease in C-peptide AUC was 293 vs.484 pmol/L (p=0.3) at 6 months, and 567 vs. 919 pmol/L (p=0.1) at 12 months in GFD and control group, respectively. The GFD group had a lower insulin dose by 0.22 U/kg/day (p=0.007), lower IDAA1c by 1.5 (p=0.003) and lower mean HbA1c by 7.5 mmol/mol (p=0.01) at 12 months (Figure 1). There was no difference in daily carbohydrate intake between the groups (p=0.4). Immunoreactive gluten was found in the stool of only 3 patients. Conclusions: GFD kept over the first year after T1D diagnosis was associated with lower insulin demand and lower HbA1c, although the groups did not differ in the C-peptide dynamics. Disclosure V. Neuman: None. S. Pruhova: None. M. Kulich: None. S. Koloušková: None. J. Vosahlo: None. M. Romanova: None. L. Petruzelkova: None. B. Obermannova: None. O. Cinek: None. Z. Sumnik: None. Funding Ministry of Health of the Czech Republic (16-27994A)