Coexisting Type 1 Diabetes, Persistent Symptoms, and Financial Issues Associate With Poorer Adherence to a Gluten-Free Diet in Celiac Disease After Transition From Pediatrics to Adult Care
PurposeWe evaluated adherence to a gluten-free diet and associated factors in adult celiac disease patients diagnosed in childhood.MethodsComprehensive medical data on 955 pediatric celiac disease patients was collected and study questionnaires sent to 559 who were now adults. All variables were com...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.883220/full |
| _version_ | 1811239752959000576 |
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| author | Laura Kivelä Laura Kivelä Laura Kivelä Anna Eurén Anna Eurén Marleena Repo Marleena Repo Heini Huhtala Katri Kaukinen Katri Kaukinen Kalle Kurppa Kalle Kurppa Kalle Kurppa |
| author_facet | Laura Kivelä Laura Kivelä Laura Kivelä Anna Eurén Anna Eurén Marleena Repo Marleena Repo Heini Huhtala Katri Kaukinen Katri Kaukinen Kalle Kurppa Kalle Kurppa Kalle Kurppa |
| author_sort | Laura Kivelä |
| collection | DOAJ |
| description | PurposeWe evaluated adherence to a gluten-free diet and associated factors in adult celiac disease patients diagnosed in childhood.MethodsComprehensive medical data on 955 pediatric celiac disease patients was collected and study questionnaires sent to 559 who were now adults. All variables were compared between strictly adherent and non-adherent patients.ResultsAltogether 237 adults (median age 27 years, 69% women) responded to the questionnaires a median of 18 (range 3–51) years after the childhood diagnosis. Altogether 78% were reportedly adherent and 22% non-adherent. The non-adherent patients had more concomitant type 1 diabetes (18% vs. 4%, p = 0.003), whereas the groups did not differ in demographic data or clinical and histological features at diagnosis, or in short-term dietary adherence. In adulthood, non-adherent patients found gluten-free diet more challenging (39% vs. 17%, p < 0.001) and had higher prevalence (39% vs. 19%, p = 0.004) and severity of symptoms. The main motivation factors for dietary adherence were attempts to avoid symptoms and complications, but these were considered less important and price of gluten-free products more important among non-adherent patients. Adherent and non-adherent patients did not differ in socioeconomic or lifestyle factors, comorbidities other than type 1 diabetes, self-reported general health, health concerns, follow-up, or in quality of life.ConclusionMost originally pediatric celiac disease patients reported strict dietary adherence in adulthood. However, particularly those with concomitant type 1 diabetes, persistent symptoms or financial issues may require attention during the transition from pediatric to adult care. |
| first_indexed | 2024-04-12T13:06:41Z |
| format | Article |
| id | doaj.art-1b55de9626db44aeac6ff9af5fa8d288 |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-04-12T13:06:41Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-1b55de9626db44aeac6ff9af5fa8d2882022-12-22T03:31:59ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-05-01910.3389/fnut.2022.883220883220Coexisting Type 1 Diabetes, Persistent Symptoms, and Financial Issues Associate With Poorer Adherence to a Gluten-Free Diet in Celiac Disease After Transition From Pediatrics to Adult CareLaura Kivelä0Laura Kivelä1Laura Kivelä2Anna Eurén3Anna Eurén4Marleena Repo5Marleena Repo6Heini Huhtala7Katri Kaukinen8Katri Kaukinen9Kalle Kurppa10Kalle Kurppa11Kalle Kurppa12Celiac Disease Research Center, Tampere University, Tampere, FinlandTampere Centre for Child, Adolescent and Maternal Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, FinlandChildren's Hospital and Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, FinlandCeliac Disease Research Center, Tampere University, Tampere, FinlandTampere Centre for Child, Adolescent and Maternal Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, FinlandCeliac Disease Research Center, Tampere University, Tampere, FinlandTampere Centre for Child, Adolescent and Maternal Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, FinlandFaculty of Social Sciences, Tampere University, Tampere, FinlandCeliac Disease Research Center, Tampere University, Tampere, FinlandDepartment of Internal Medicine, Tampere University Hospital, Tampere, FinlandCeliac Disease Research Center, Tampere University, Tampere, FinlandTampere Centre for Child, Adolescent and Maternal Health Research, Tampere University and Department of Pediatrics, Tampere University Hospital, Tampere, FinlandThe University Consortium of Seinäjoki and Department of Pediatrics, Seinäjoki Central Hospital, Seinäjoki, FinlandPurposeWe evaluated adherence to a gluten-free diet and associated factors in adult celiac disease patients diagnosed in childhood.MethodsComprehensive medical data on 955 pediatric celiac disease patients was collected and study questionnaires sent to 559 who were now adults. All variables were compared between strictly adherent and non-adherent patients.ResultsAltogether 237 adults (median age 27 years, 69% women) responded to the questionnaires a median of 18 (range 3–51) years after the childhood diagnosis. Altogether 78% were reportedly adherent and 22% non-adherent. The non-adherent patients had more concomitant type 1 diabetes (18% vs. 4%, p = 0.003), whereas the groups did not differ in demographic data or clinical and histological features at diagnosis, or in short-term dietary adherence. In adulthood, non-adherent patients found gluten-free diet more challenging (39% vs. 17%, p < 0.001) and had higher prevalence (39% vs. 19%, p = 0.004) and severity of symptoms. The main motivation factors for dietary adherence were attempts to avoid symptoms and complications, but these were considered less important and price of gluten-free products more important among non-adherent patients. Adherent and non-adherent patients did not differ in socioeconomic or lifestyle factors, comorbidities other than type 1 diabetes, self-reported general health, health concerns, follow-up, or in quality of life.ConclusionMost originally pediatric celiac disease patients reported strict dietary adherence in adulthood. However, particularly those with concomitant type 1 diabetes, persistent symptoms or financial issues may require attention during the transition from pediatric to adult care.https://www.frontiersin.org/articles/10.3389/fnut.2022.883220/fullceliac diseasetype 1 diabetesgluten-free diettransition of carecomorbidityfollow-up |
| spellingShingle | Laura Kivelä Laura Kivelä Laura Kivelä Anna Eurén Anna Eurén Marleena Repo Marleena Repo Heini Huhtala Katri Kaukinen Katri Kaukinen Kalle Kurppa Kalle Kurppa Kalle Kurppa Coexisting Type 1 Diabetes, Persistent Symptoms, and Financial Issues Associate With Poorer Adherence to a Gluten-Free Diet in Celiac Disease After Transition From Pediatrics to Adult Care Frontiers in Nutrition celiac disease type 1 diabetes gluten-free diet transition of care comorbidity follow-up |
| title | Coexisting Type 1 Diabetes, Persistent Symptoms, and Financial Issues Associate With Poorer Adherence to a Gluten-Free Diet in Celiac Disease After Transition From Pediatrics to Adult Care |
| title_full | Coexisting Type 1 Diabetes, Persistent Symptoms, and Financial Issues Associate With Poorer Adherence to a Gluten-Free Diet in Celiac Disease After Transition From Pediatrics to Adult Care |
| title_fullStr | Coexisting Type 1 Diabetes, Persistent Symptoms, and Financial Issues Associate With Poorer Adherence to a Gluten-Free Diet in Celiac Disease After Transition From Pediatrics to Adult Care |
| title_full_unstemmed | Coexisting Type 1 Diabetes, Persistent Symptoms, and Financial Issues Associate With Poorer Adherence to a Gluten-Free Diet in Celiac Disease After Transition From Pediatrics to Adult Care |
| title_short | Coexisting Type 1 Diabetes, Persistent Symptoms, and Financial Issues Associate With Poorer Adherence to a Gluten-Free Diet in Celiac Disease After Transition From Pediatrics to Adult Care |
| title_sort | coexisting type 1 diabetes persistent symptoms and financial issues associate with poorer adherence to a gluten free diet in celiac disease after transition from pediatrics to adult care |
| topic | celiac disease type 1 diabetes gluten-free diet transition of care comorbidity follow-up |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.883220/full |
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