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Metabolic Control of Type 1 Diabetes in Youth with Autism Spectrum Disorder: a Multicenter DPV analysis based on 61,749 patients up to 20 years of age.

Pediatr Diabetes. 2018 Mar 26;:

Authors: Lemay JF, Lanzinger S, Pacaud D, Plener PL, Fürst-Burger A, Biester T, Hilgard D, Lilienthal E, Galler A, Berger G, Holl RW, German/Austrian DPV Initiative

Abstract
A paucity of reports in the literature exists concerning the co-existence between Autism Spectrum Disorder (ASD) and type 1 diabetes (T1D).
OBJECTIVE: To compare clinical characteristics, diabetes management and metabolic control in youth with T1D and ASD (T1D-ASD) with youth without ASD (T1D-non ASD).
PATIENTS AND METHODS: Using the German/Austrian diabetes patient follow-up registry (DPV), this study analyzed aggregated data from the last available year of observation for each patient with T1D, ages 1-20 with consistent data on insulin regimen and glycated hemoglobin (A1C), between January 2005-March 2017.
RESULTS: From 61,749 patients, 150 (0.24%) were identified as T1D-ASD. Non-adjusted comparisons showed similar results for mean age at onset and duration of diabetes, but not for gender (male: T1D-ASD: 85.3%; T1D-non ASD: 52.8%; p<0.001). Unadjusted comparisons showed no difference for severe hypoglycemia, diabetic ketoacidosis, insulin doses, insulin pump therapy, and body mass index. A statistical difference was observed for A1C (p-value 0.01) and in the number of blood glucose (SMBG) tests/day (median [interquartile range]: T1D-ASD 6.0 [4.4-7.0]; T1D-non ASD 5.0 [4.4-7.0]; p-value<0.001). After adjusting for age, gender, duration of diabetes, and year of observation, only SMBG remained significant (p-value 0.003). T1D-ASD used psycho-stimulants (15.3% vs. 2.2%; p-value<0.001), anti-psychotics (10.7% vs. 0.6%; p-value<0.001), and anti-depressive medications (3.6% vs. 0.7%; p-value<0.001) more frequently.
CONCLUSION: Metabolic control was similar in the T1D-ASD group compared to T1D-non ASD despite their comorbidity. Awareness of ASD remains important in T1D treatment, as both conditions require long-term multi-disciplinary medical follow-up for optimal outcomes.

PMID: 29582531 [PubMed – as supplied by publisher]

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