{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:53:49Z","timestamp":1761519229161,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T00:00:00Z","timestamp":1508716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Both Type 1 diabetes mellitus (T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>) and coeliac disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>) are independently associated with reduced bone mineral density (<jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>) and increased fracture risk. Whilst poorer glycaemic control and increased microvascular complications have been described, the literature examining bone health and fractures in adults with concomitant T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> (T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>) is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate fracture prevalence and explore associations with glycaemic control, hypoglycaemia and microvascular disease in T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> compared with T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cross\u2010sectional study of young adults with T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>, who attended diabetes clinics at a large tertiary referral centre between August 2016 and February 2017. Clinical information, radiological and biochemistry results were extracted from medical records. Patients with comorbid chronic kidney disease, glucocorticoid use, hypogonadism and untreated hyperthyroidism were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 346 patients with T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> alone (median age 23\u00a0years) and 49 patients with T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> (median age 24\u00a0years) were included. Median age, gender distribution, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>, haemoglobin A1c, daily insulin dose and serum 25\u2010hydroxyvitamin D levels were similar between groups. Higher adjusted fracture risk was observed in T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> compared with T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content> (12.2% vs 3.5%; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.50, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.01\u201012.12, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01), yet BMD was only measured in 6% of patients. The adjusted risk of hypoglycaemia \u22652\/week was greater for T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> (55% vs 38%, <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.28, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.61\u20106.69, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001); however, this was not independently associated with fractures. Replete vitamin D (\u2265 50\u00a0nmol\/L) was associated with less hypoglycaemia (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.48, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.29\u20100.80; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.005), but not with fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Coeliac disease status was independently associated with increased fracture prevalence in young adults with T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>. Recurrent hypoglycaemia was also increased in T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>\u00a0+\u00a0<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>, although hypoglycaemia was not independently associated with fractures. Prospective studies are required to determine the long\u2010term impacts of <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> on bone health and glycaemic control in patients with T1<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13488","type":"journal-article","created":{"date-parts":[[2017,9,28]],"date-time":"2017-09-28T16:46:37Z","timestamp":1506617197000},"page":"37-43","source":"Crossref","is-referenced-by-count":13,"title":["Increased prevalence of fracture and hypoglycaemia in young adults with concomitant type 1 diabetes mellitus and coeliac disease"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4156-5150","authenticated-orcid":false,"given":"Eleanor P.","family":"Thong","sequence":"first","affiliation":[{"name":"Departments of Endocrinology and Diabetes Monash Health Clayton Vic. 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Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena J.","family":"Teede","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology and Diabetes Monash Health Clayton Vic. Australia"},{"name":"Monash Centre for Research &amp; Health Implementation Clayton Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances","family":"Milat","sequence":"additional","affiliation":[{"name":"Departments of Endocrinology and Diabetes Monash Health Clayton Vic. Australia"},{"name":"Hudson Institute of Medical Research Clayton Vic. 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