Childhood type 1 diabetes risk unaffected by autism
Children with type 1 diabetes are no more likely to have autism spectrum disorder than children without the condition, although those with autism spectrum disorder may display some superior diabetes management outcomes, according to findings published in Diabetic Medicine.
“Diabetes and autism spectrum disorder are each challenging to manage on their own. It is important to know whether youth with both conditions face extra challenges,” Kathleen Bethin, MD, PhD, professor of pediatrics at the University at Buffalo Jacobs School of Medicine & Biomedical Sciences and attending physician at John R. Oishei Children’s Hospital in Buffalo, New York, told Endocrine Today. “This research also sets the stage for further studies to investigate what are the factors leading to improved HbA1c in youth who are diagnosed with both conditions.”
Bethin and colleagues examined data from 10,032 children with type 1 diabetes (mean age, 13 years; 51.7% girls; median disease duration, 6.5 years) included in the T1D Exchange registry. Medical data, including information on diabetic ketoacidosis, insulin delivery preference and the presence of autism spectrum disorders, such as autism, Asperger’s and pervasive developmental disorder, were collected from records of examinations from June 2016 to September 2017.
The researchers identified autism spectrum disorder (ASD) in 159 children, who accounted for 1.58% of the study population, “similar to the general U.S. population rate of 1.69%,” the researchers wrote. Eighty-eight percent of the children with ASD were boys vs. 51% of those without ASD (P < .001).
“There does not seem to be an increased incidence of ASD in youth with type 1 diabetes, although a larger study is needed to see if there may an increased prevalence of ASD in males with type 1 diabetes,” Bethin said. “In addition, compared to youth with type 1 diabetes alone, it is very possible to successfully manage diabetes in youth with both type 1 diabetes and ASD.”
Fifty-two percent of participants with ASD were on insulin pump therapy, compared with 63% of those without ASD (P = .005). Meanwhile, the researchers noted that there were no significant differences in diabetic ketoacidosis, severe hypoglycemia or continuous glucose monitor use between those with and without ASD.
“Given the developmental challenges and mental health problems associated with ASD, it is not surprising that pump use is less frequent in those with ASD,” the researchers wrote.
Children with ASD had an average HbA1c level of 8.4% vs. 8.5% among those without ASD (P < .006). In addition, children with ASD checked their blood glucose 4.2 times per day, whereas those without ASD checked four times per day (P = .011). The researchers also found that children with ASD had numerically reduced levels of total cholesterol, but this finding did not reach significance.
“The lower HbA1c, higher number of daily blood glucose checks and trend toward lower cholesterol might suggest that those with ASD are more regimented in their diabetes and dietary management or that those with ASD are more likely to have an adult manage their diabetes through adolescence,” the researchers wrote. – by Phil Neuffer
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Kathleen Bethin, MD, PhD, can be reached at firstname.lastname@example.org.
Disclosures: The authors report no relevant financial disclosures.