Celiac disease (CD), prevalent across Mediterranean countries, remains underdiagnosed despite its commonality. Traditionally regarded as a rare pediatric digestive disorder, CD now presents as a systemic condition affecting all age groups, raising serious concerns about frequent misdiagnoses and the potential for severe long-term complications such as osteopenia, delayed puberty, and increased risk of associated autoimmune diseases and malignancies. Recent changes in its clinical spectrum include an increased age at diagnosis, a shift from classical gastrointestinal symptoms to less overt manifestations like isolated growth retardation, and a notable prevalence among children with type 1 diabetes mellitus (T1DM). This evolving scenario underscores a critical gap in our comprehensive understanding of CD's impact and prevalence.

This Research Topic aims to refine the understanding of CD's burden in Mediterranean countries by focusing on its diagnosis, management, and intersection with dietary practices and comorbid conditions such as T1DM. It seeks to explore how shifts in symptomatology and demographic patterns of CD affect diagnosis rates and healthcare strategies. Additionally, considering the unique dietary challenges and opportunities within the Mediterranean context, this topic will investigate how regional dietary habits influence the management of CD and patient outcomes, particularly in light of contemporary findings advocating for a Mediterranean diet as a beneficial supplement to the gluten-free diet (GFD) traditionally prescribed for CD patients.

To gather further insights into the dynamic landscape of celiac disease in Mediterranean settings, we welcome articles addressing, but not limited to, the following themes:

• Epidemiology of celiac disease in the Mediterranean region.
• Advances in serological screening and diagnostic techniques for early detection.
• The relationship between celiac disease and type 1 diabetes mellitus.
• Dietary intervention studies focusing on the Mediterranean diet as a complementary approach to GFD.
• Impact of dietary adherence on quality of life and nutritional status in celiac patients.
• Long-term complications associated with misdiagnosed or untreated celiac disease.

We encourage submissions of various types including literature reviews, original research articles, and updates on recent advancements in the field.

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Evolving Paradigms of Celiac Disease in Mediterranean Countries