Autism spectrum disorder in children with Type 1 diabetes

Area of Science:

• Endocrinology
• Neurodevelopmental Disorders
• Pediatric Health

Background:

• Autism spectrum disorder (ASD) and autoimmune diseases, including Type 1 diabetes, share proposed links.
• Understanding the co-occurrence and impact of ASD in pediatric Type 1 diabetes is crucial for comprehensive care.

Purpose of the Study:

• To determine the frequency of ASD in children with Type 1 diabetes using the T1D Exchange registry.
• To investigate the influence of ASD on the clinical characteristics and management of Type 1 diabetes in children.

Main Methods:

• Analysis of 10,032 participants under 18 years old from the T1D Exchange registry.
• Defined ASD diagnosis as autism, Asperger's, or pervasive developmental disorder.
• Compared demographic and clinical data between children with and without ASD.

Main Results:

• ASD was recorded in 1.58% of participants, predominantly males.
• Similar rates of diabetic ketoacidosis at diagnosis were observed between groups.
• Lower insulin pump use was noted in children with ASD, while continuous glucose monitor use was comparable.
• A slightly lower median HbA1c was observed in children with ASD, even after adjusting for confounders.

Conclusions:

• The prevalence of ASD in the T1D Exchange registry aligns with general population estimates.
• Despite communication challenges, key diabetes complications like diabetic ketoacidosis were similar.
• Differences in device use (lower pump use) and glycemic control (lower HbA1c) in ASD may relate to sensory factors or structured routines.
• Further research is essential to support children with Type 1 diabetes and co-occurring ASD.