Comorbidity Of Inflammatory Bowel Disease In Children And Adolescents With Type 1 Diabetes

Aim To determine the prevalence of inflammatory bowel disease (IBD) in patients with type 1 diabetes (T1D) and to characterise patients with both diseases.Methods Data of 65.147 patients with T1D <= 18 years of 379 centres in Germany and Austria participating in the DPV initiative were analysed. A total of 63 children had comorbid IBD; IBD prevalence was 0.1%. Regression models were used to analyse differences in metabolic control, acute complications and steroid intake.Results Mean BMI-SDS in patients with T1D and IBD was lower (-0.15 +/- 0.11) compared to patients with T1D only (0.27 +/- 0.00, p < .001). Patients with T1D and IBD had a significantly higher use of steroids (22% +/- 0.05% vs. 1% +/- 0.00, p < .001) and a significantly higher rate of severe hypoglycaemic events per patient year (0.33 +/- 0.07 vs. 0.16 +/- 0.00, p = .001). No differences were found in HbA1c levels, insulin dose and occurrence of DKA.Conclusion Although children and adolescents with T1D and IBD take steroids more often, they suffer from severe hypoglycaemia more frequently and have a lower BMI-SDS. These findings might be explained by chronic intestinal inflammation leading to malabsorption, malnutrition and increased severe hypoglycaemia.