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Glycemic Control and Diabetes Related Complications in Adults with Type 1 Diabetes Mellitus and ADHD

Michal Vinker-Shuster1, Roy Eldor2,3, Ilan Green4,5

  • 1Assuta Ashdod University Hospital, Israel.

Journal of Attention Disorders
|December 22, 2021
PubMed

Insights

Adults with type-1 diabetes mellitus (T1DM) and attention-deficit/hyperactivity disorder (ADHD) exhibit poorer glycemic control and increased diabetes-related complications. Stimulant treatment in ADHD patients with T1DM was linked to improved outcomes.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Neurodevelopmental Disorders

Background:

  • Type-1 diabetes mellitus (T1DM) requires lifelong management to prevent complications.
  • Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that can impact self-management of chronic conditions.
  • The interplay between T1DM and ADHD comorbidities is not fully understood, particularly regarding diabetes-related complications.

Purpose of the Study:

  • To investigate the correlation between comorbid ADHD and the prevalence of diabetes-related complications in adult patients with T1DM.
  • To compare glycemic control (HbA1c levels) and complication rates between T1DM patients with and without ADHD.

Main Methods:

  • A retrospective cross-sectional study utilizing the Leumit Health Services database in 2018.
  • Patients with T1DM and ADHD (T1DM-ADHD+) were identified and compared to a matched cohort of T1DM patients without ADHD (T1DM-ADHD-).
  • Diabetes-related complications, including neuropathy, ulcers, amputations, albuminuria, chronic renal failure, and emergency room admissions, were assessed.

Main Results:

  • The T1DM-ADHD+ group (9.5% of 789 patients) showed significantly higher HbA1c levels (8.1% vs. 7.4%, p < .01).
  • Elevated rates of diabetes-related complications were observed in the T1DM-ADHD+ group, including neuropathy (22.7% vs. 5.8%), ulcers (8% vs. 0.9%), limb amputations (5.3% vs. 0.9%), albuminuria (15.5% vs. 2.8%), chronic renal failure (10.6% vs. 2.5%), and ER admissions (26.7% vs. 15.1%) (all p < .05).
  • Sub-analysis indicated that ADHD patients with T1DM treated with stimulants had lower average HbA1c and reduced diabetic ulcer rates (p < .05).

Conclusions:

  • Comorbidity of ADHD in patients with T1DM is associated with significantly poorer glycemic control.
  • The presence of ADHD in T1DM patients is linked to a higher incidence of serious diabetes-related complications.
  • Stimulant therapy may offer a beneficial effect on glycemic control and complication rates in T1DM patients with ADHD.
Abstract

Keywords:
ADHDHbA1Cdiabetestype 1 diabetes

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