Autism Does Not Affect Metabolic Control in Type 1 Diabetes

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Youths with T1D and ASD performed a higher number of self-monitoring blood glucose tests per day.
Youths with T1D and ASD performed a higher number of self-monitoring blood glucose tests per day.

Metabolic control of type 1 diabetes (T1D) is comparable in children and young adults with and without autism spectrum disorder (ASD), according to a study published in Pediatric Diabetes.

High levels of co-occurring medical conditions have been observed in children and young adults with ASD. The goal of this study was to compare clinical characteristics, diabetes management, and metabolic control in children and young adults with T1D and ASD vs children and young adults with T1D without ASD.  

Investigators collected data from the German/Austrian diabetes patient follow-up registry for analysis. The sample was comprised of a total of 61,749 patients age 1 through 20 years, 150 (0.24%) of whom had T1D and ASD. The database included information on patient demographics, diabetes treatment, and outcome measures.

Results showed significantly higher percentages of boys with T1D and ASD vs boys with T1D without ASD (85.3% vs 52.8%, respectively; P <.001). Additionally, hemoglobin A1c levels were significantly higher among participants with T1D and ASD vs participants with T1D without ASD (P <.01). Furthermore, children and young adults with T1D and ASD performed a higher number of self-monitoring blood glucose tests per day compared with children and young adults with T1D without ASD (median 6.0 [interquartile range 4.4-7.0] vs 5.0 [interquartile range 4.4-7.0], respectively; P <.001).

Adjustments for age, gender, duration of diabetes, and year of observation yielded significant differences in self-monitoring blood glucose (P <.003) but not HbA1c levels. 

No differences reached thresholds of significance for parameters such as mean age at diabetes onset, disease duration, acute diabetic complications, insulin doses, insulin pump therapy, and body mass index.

Children and young adults with T1D and ASD had significantly higher medication use vs children and young adults with T1D without ASD, including the use of psychostimulant (15.3% vs 2.2%; P <.001), antipsychotic (10.7% vs 0.6%; P <.001), and antidepressant medications (3.6% vs 0.7%; P <.001).

The study was limited by the use of clinical information based on subjective reports and challenges associated with identifying patients with ASD correctly.

“Despite their ASD condition and use of medication with potential adverse effects on glucose metabolism, metabolic control was similar in [children and young adults with T1D and ASD],” the authors commented. However, “[a]wareness of ASD remains important in T1D treatment, as both conditions require long-term multidisciplinary medical follow-up for optimal outcomes,” concluded the authors.

Reference

Lemay JF, Lanzinger S, Pacaud D et al; German/Austrian DPV Initiative. Metabolic control of type 1 diabetes in youth with autism spectrum disorder: a multicenter Diabetes-Patienten-Verlaufsdokumentation analysis based on 61 749 patients up to 20 years of age [published online March 26, 2018]. Pediatr Diabetes. doi:10.1111/pedi.12676

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