International Society for Pediatric and Adolescent Diabetes
ISPAD 2014 | 40th Anniversary |
253
P165
Type and frequency of reported gastrointestinal symptoms in pediatric & adult type 1 diabetes
patients evaluated as part of the CD-DIET study
K. Noordin
1
, E. DeMelo
1
, M.A. Marcon
2
, E. Assor
1
, E. Cutz
3
, J. Davies-Shaw
1
, K. Sahota
1
, A. Advani
4
,
K. Bax
5
, M.D. Beaton
6
, M. Cino
7
, P. Gallego
8
, J. Gilbert
9
, S. Kirsch
10
, D. Koltin
11
, M.L. Lawson
12
, D.R.
Mack
13
, C. McDonald
14
, G. Mukerji
15
, B.A. Perkins
16
, F. Saibil
17
, E. Szentgyorgi
18
, F.H. Mahmud
1
1
The Hospital for Sick Children, Division of Endocrinology, Toronto, Canada,
2
The Hospital for Sick
Children, Division of Gastroenterology, Hepatology and Nutrition, Toronto, Canada,
3
The Hospital for
Sick Children, Department of Pathology, Toronto, Canada,
4
St. Michael's Hospital, Division of
Endocrinology, Toronto, Canada,
5
Children's Hospital, London Health Sciences Centre, Pediatric
Gastroenterology, London, Canada,
6
London Health Sciences Centre, Division of Gastroenterology,
London, Canada,
7
Toronto Western Hospital, University Health Network, Division of Gastroenterology,
Toronto, Canada,
8
Children's Hospital, London Health Sciences Centre, Division of Endocrinology,
London, Canada,
9
Sunnybrook Health Sciences Centre, Division of Endocrinology and Metabolism,
Toronto, Canada,
10
Markham Stouffville Hospital, Division of Endocrinology, Markham, Canada,
11
Credit Valley Hospital, Trillium Health Partners, Division of Endocrinology, Toronto, Canada,
12
Children's Hospital of Eastern Ontario, Division of Endocrinology and Metabolism, Ottawa, Canada,
13
Children's Hospital of Eastern Ontario, Division of Gastroenterology, Hepatology and Nutrition,
Ottawa, Canada,
14
St. Joseph's Health Care, London Health Sciences Centre, Division of
Endocrinology and Metabolism, London, Canada,
15
Women's College Hospital, Division of
Endocrinology, Toronto, Canada,
16
Toronto General Hospital, University Health Network, Division of
Endocrinology and Metabolism, Toronto, Canada,
17
Sunnybrook Health Sciences Centre, Division of
Gastroenterology, Toronto, Canada,
18
Toronto General Hospital, University Health Network,
Department of Pathology, Toronto, Canada
Type 1 Diabetes (T1D) patients present with gastrointestinal (GI) symptoms related to diabetes
complications but also to other associated pathologies.
Objectives:
To describe GI symptoms reported by children and adult patients with T1D assessed as
part of the screening phase of the Celiac Disease & Diabetes - Dietary Intervention & Evaluation Trial
(CD-DIET).
Methods:
Individuals aged 8-
35 years with T1D duration ≥ 1 year completed a self
-reported
questionnaire - Gastrointestinal Symptom Scale (GISS) to qualify for CD serology screening
(
). GI symptoms were evaluated over the previous 7 days, with an 8-item
symptom questionnaire which included no symptoms, upper and lower abdominal pain, loss of
appetite, nausea, loose or hard stool, vomiting and a Visual Analog Score (VAS, 0-100) to assess
symptom severity. Age categories were defined as children ≤ 18 years and adults > 18 years.
Results:
954 patients are reported: 751 (78%) children and 203 (22%) adults. Overall, 82.4% children
and 81.1% adults reported no GI symptoms. In the group that had symptoms, adults most frequently
reported lower (22.2%) and upper (20.6%) abdominal pain and loose stool (19%) while children
reported lower (28.3%) and upper (22%) abdominal pain and nausea (16.1%) as main symptoms.
Mean for the VAS score were low for both groups: 5.8/100 in children and 6.0/100 for adults. In
subjects reporting at least one GI symptom, a correlation between number of symptoms and severity
a
s measured by the VAS score was seen in children (p=0.019) and adults (p=0.005). Adults with ≥ 3
symptoms revealed a trend towards a greater increase in the VAS score (p=0.05).
Conclusions:
The frequency of GI symptoms was low in both pediatric and adult T1D subjects
screened in clinic. The pattern of symptoms differed between the age groups and a stronger
correlation was seen between number of symptoms and the severity in adults.
