Endocrine Abstracts

JOINT2249

Background: Managing type 1 diabetes (T1D) in children with neurodiversity presents unique challenges. This population often faces difficulties with communication, sensory sensitivities, and adherence to complex medical regimens meaning that management of chronic disease can be difficult. These challenges are further compounded by variations in cognitive abilities and social understanding, requiring tailored strategies for effective diabetes care. However, they have also had to overcome significant barriers in day-to-day life and education and this resilience may help in self-management of complex management of T1D. We explore the impact of neurodiversity on diabetes self-management and caregiving dynamics, aiming to highlight evidence-based interventions, the importance of interdisciplinary collaboration, and the role of assistive technologies. Co-morbidity of autism spectrum disorder and T1D has been shown to have poorer outcomes of diabetic control, but there is little evidence available on how these patients show resilience in managing their diabetes and what challenges they face.

Methods: This qualitative study explores the lived experiences of children with co-occurring neurodiverse diagnosis and T1D, alongside their primary caregivers. We completed semi-structured interviews with 10 adolescents and parents to understand the unique barriers and how these families have shown resilience in managing these dual conditions. The interviews focussed on diabetes education, the interplay between neurodiversity and diabetes, diabetes technologies, personal management and transition, and the impact on daily life.

Results: Thematic analysis revealed five key themes: management and fear of hypoglycaemia, worries regarding future planning and transition, use of diabetes technology, sleep, and support structures and relationships. Both patients and their caregivers noted that diabetes technology, including continuous glucose monitoring (CGM), reduced anxiety and improved sleep quality. Patients also highlighted that they did not feel that their neurodiverse diagnoses impacted on their management of T1D. Families also recognised that there was a lack of general resources covering neurodiversity and T1D.

Conclusion: We have highlighted the resilience that families demonstrate in managing T1D alongside neurodiversity. This study underscores the need for personalised, neurodiversity-affirming care models that integrate behavioural strategies and caregiver training to optimise health outcomes. The findings highlight the importance of fostering collaborative care frameworks to address the dual demands of neurodiversity and T1D, promoting improved quality of life for both children and their families.