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

Lemay, Jean-François; Lanzinger, Stefanie; Pacaud, Danièle; Plener, Paul L.; Fürst-Burger, A.; Biester, Torben; Hilgard, Dörte; Lilienthal, Eggert; Galler, Angela; Berger, Gabriele; Holl, Reinhard W.

doi:10.1111/pedi.12676

Cited by 7 publications

(10 citation statements)

References 26 publications

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“…Interestingly, our data show a male to female ratio of 7.4:1 in participants in the T1DX compared with 4:1 in the general US population for ASD diagnosis [3,8]. The DPV data showed a 5.8:1 ratio of males to females in youth with ASD and Type 1 diabetes compared with a 2-3:1 ratio of males to females in the general German population with ASD [20,23]. Despite difficulties with social communication, the data from both the T1DX and DPV studies demonstrated no difference in diabetic ketoacidosis at presentation and during treatment, as well as no differences in severe hypoglycaemia events.…”

Section: Discussionmentioning

confidence: 45%

“…Interestingly, our data show a male to female ratio of 7.4:1 in participants in the T1DX compared with 4:1 in the general US population for ASD diagnosis . The DPV data showed a 5.8:1 ratio of males to females in youth with ASD and Type 1 diabetes compared with a 2–3:1 ratio of males to females in the general German population with ASD .…”

Section: Discussionmentioning

confidence: 46%

“…The DPV data, when controlled for age, gender, duration of diabetes and year of observation, show that Type 1 diabetes metabolic control is not affected by the additional diagnosis of ASD. However, the prevalence of ASDs is much lower in the DPV compared with the T1DX cohort [3,8,20,23].…”

Section: Introductionmentioning

confidence: 88%

“…Some of these studies have shown an increased prevalence of ASD in children with Type 1 diabetes compared with the general population, whereas others have shown no difference. Recently, the German/Austrian Diabetes Patient Follow‐Up registry (DPV) examined clinical characteristics and metabolic control in youth (1–20 years) enrolled in the DPV registry with Type 1 diabetes and ASD . The DPV data did not demonstrate a difference in prevalence of ASD in the youth with Type 1 diabetes.…”

Section: Introductionmentioning

confidence: 99%

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Autism spectrum disorder in children with Type 1 diabetes

et al. 2019

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Aim Links between autism spectrum disorder (ASD) and autoimmune diseases, including Type 1 diabetes have been proposed. This study assessed the frequency of ASD in children with Type 1 diabetes in the T1D Exchange (T1DX) registry and the impact of ASD on characteristics of children with Type 1 diabetes.Methods Analysis included 10 032 participants aged < 18 years (median Type 1 diabetes duration 6.5 years, 48% female, 77% non-Hispanic White). Diagnosis of ASD was defined as autism, Asperger's or pervasive developmental disorder.Results A diagnosis of ASD was recorded for 159 (1.58%) participants. Those with ASD were predominantly male (88% vs. 51% of those without ASD, P < 0.001) and slightly older (median 14 vs. 13 years, P = 0.022). Occurrence of diabetic ketoacidosis at Type 1 diabetes diagnosis was similar (35% vs. 41%, P = 0.161). Pump use was lower in those with ASD (51% vs. 63%, P = 0.005) but continuous glucose monitor use was similar (24% vs. 27%, P = 0.351). Median HbA 1c was slightly lower in those with ASD [68 vs. 69 mmol/mol (8.4% vs. 8.5%), P = 0.006]. This difference was more pronounced after adjusting for confounders. ConclusionsThe frequency of ASD in the T1DX registry was similar to that in the general population. These data show that despite deficits in communication, occurrence of diabetic ketoacidosis was similar in youth with and without ASD. Pump use was less frequent in those with ASD, possibly due to sensory issues, although CGM use did not differ. The lower HbA 1c may be due to a more regimented routine with ASD. Because comorbidities such as ASD complicate care of patients with Type 1 diabetes, further research is needed to support these children.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 46%

Section: Introductionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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Autism spectrum disorder in children with Type 1 diabetes

et al. 2019

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“…Prevalence of ASD: The prevalence of ASD in the Colorado pediatric population with T1D (1.16%) was similar to the prevalence of ASD in those with T1D in Ontario (0.9%), but higher than the prevalence of ASD in Ontario's general population (0.7%) and higher than the ASD prevalence in T1D in other countries, such as, Finland (0.14%), and Italy (0.72%) . Recently, the German/Austrian diabetes patient follow‐up registry, Diabetes‐Patienten‐Verlaufsdokumentation (DPV), reported the prevalence of comorbid ASD in T1D aged <20 years as 0.24%, but the prevalence of ASD in the general population was not provided . Differences in prevalence rates across the world may be because of differences in diagnostic criteria or in “diagnostic awareness” between countries.…”

Section: Discussionmentioning

confidence: 77%

Prevalence, characteristics, and diabetes management in children with comorbid autism spectrum disorder and type 1 diabetes

et al. 2019

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Objective: To determine autism spectrum disorder (ASD) prevalence within our pediatric type 1 diabetes (T1D) clinic population and determine clinical characteristics and technology used by individuals with both ASD and T1D compared to matched controls with T1D alone and compared to our overall pediatric T1D clinic.Methods: Medical chart review showed 30 individuals with both ASD and type 1 diabetes (ASD + T1D). Controls (n = 90) were matched for age, sex, race/ethnicity, and T1D duration. ASD + T1D was compared to both matched controls and the pediatric T1D clinical population.Results: ASD prevalence in the pediatric T1D population was 1.16% (CI 0.96-1.26).Compared to the T1D clinic, ASD + T1D had more males (93% vs 52%; P < 0.0001), lower hemoglobin A1c (HbA1c) (8.2% vs 8.9%; 66 vs 74 mmol/mol; P = 0.006), and lower insulin pump (CSII) use (37% vs 56%; P < 0.0001). No differences were found between ASD + T1D and matched controls in HbA1c or blood glucose checks per day. The ASD + T1D group was less likely to use CSII than matched controls (37% vs 61%; P = 0.03). HbA1c did not change after CSII initiation in ASD + T1D, but increased for matched controls.Conclusions: Prevalence of ASD in the pediatric T1D population is comparable to the general population in Colorado. Individuals with ASD may experience barriers limiting CSII use, but achieve equivalent glycemic control compared to those without ASD.CSII may be more effective in maintaining lower HbA1c over time in those with ASD than in those without ASD. K E Y W O R D S autistic disorder, diabetes mellitus, disease management, pediatrics, type 1 Type 1 diabetes (T1D) is one of the most common chronic diseases of childhood, 1,2 requiring complex management and multiple daily interventions to administer insulin and monitor blood sugars. Psychological comorbidities, such as depression have been extensively studied in T1D. However, existing research on T1D and developmental disorders, specifically autism spectrum disorder (ASD), is extremely sparse. Impairments in social behavior and reciprocal social interactions are hallmark features of ASD. 3 Individuals with ASD show delayed language development, deficits in social-emotional reciprocity, eye

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Beyond the brain: A multi-system inflammatory subtype of autism spectrum disorder

et al. 2019

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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

Abstract: 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.

Cited by 7 publications

References 26 publications

Autism spectrum disorder in children with Type 1 diabetes

Autism spectrum disorder in children with Type 1 diabetes

Prevalence, characteristics, and diabetes management in children with comorbid autism spectrum disorder and type 1 diabetes

Beyond the brain: A multi-system inflammatory subtype of autism spectrum disorder

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