Endocrine Abstracts

Introduction: Type 1 diabetes (T1DM) is characterized by symptoms caused by elevated blood glucose due to insulin deficiency caused by pancreatic b-cells loss. There may be a potential link between T1DM and neurodevelopmental disorders in children and adolescents (CYP), needing more studies to understand the underlying pathogeneses. Neurodevelopmental disorders, such as attention-deficit/ hyperactivity disorder (ADHD), autism spectrum disorder (ASD) are characterised by learning difficulties, attention, memory and social communication problems. These impairments can undermine patients’ abilities to execute complex tasks compromising glycaemic control, increasing risk of complications. The prevalence of ASD in the UK is 1-2% and ADHD is 3-4%. Our aim was to find out prevalence of ASD/ADHD in CYP with T1DM and to compare glycaemic control among patients with and without ASD/ADHD.

Methods: Data was collected to find out CYP with T1DM and ASD/ADHD under Royal Derby Hospital, average HBA1c (lowest, highest and latest), type of treatment (MDI/Pump), presence of associations and complications, age, gender, duration of Diabetes.

Results: Total Patients with T1DM were 271. In Patients with T1DM and either ASD, ADHD or both (21, 7.7% of 271), with ASD were 14 (5.2% of 271), ADHD 3 (1.1% of 271), ASD and ADHD 04 (1.4% of 271), males 9 (42.9%), females 12 (57.1%), mean age 13.3 yrs, mean diabetes duration 6 yrs, median HBA1c mmol/mol 66.3. Patients on MDI therapy 1 (4.8%), insulin pump therapy 20 (95.2%), patients with hypothyroidism 02 (9.5%), Coeliac disease 02 (9.5%) Nephropathy 01 (4.8%). In patients with T1DM without neurodevelopmental diagnosis (250) males were129 (51.6%), females 121 (48.4%), mean Age 12.8 yrs, mean diabetes duration 5yrs 5months, median HBA1c 65.3 mmol/mol. Patients using MDI 28 (11.2%), insulin pump therapy 222 (88.8%), hypothyroidism 05 (2%), Coeliac disease 11 (4.4%), Nephropathy 03 (1.2%), Hypertension 01 (0.4%).

Discussion: Our data showing increased Prevalence of ASD/ADHD in CYP with T1DM highlights the importance of early screening for neurodevelopmental disorders in children with Type 1 DM. Higher HBA1c in CYP with T1DM and neurodevelopmental disorders (ASD/ADHD) favours considering enhanced standards for management in patients with T1DM having neurodevelopmental disorders.