Testing for Lipid Levels and Diabetes Among Youth With Autism Who Are and Are Not Prescribed Antipsychotics: A Cohort...

Autistic youth have higher rates of hyperlipidemia and diabetes than nonautistic youth and thus need age-appropriate monitoring for these conditions. Little is known about how frequently autistic youth are monitored for hyperlipidemia and diabetes.

This analysis assessed monitoring for hyperlipidemia and diabetes among 230 autistic youth aged 16-30 years (113 were prescribed antipsychotics, 117 were not) between January 2011 and May 2020. Outcomes assessed included the proportion of patients who had any testing for hyperlipidemia and diabetes in both groups, the proportion of patients monitored for hyperlipidemia and diabetes in the last year, and the identification of patient factors associated with monitoring.

A significantly higher proportion of autistic youth prescribed antipsychotics had testing for both hyperlipidemia and diabetes during the study period than autistic youth who were not (73% vs 49%, p<0.001). Although most autistic youth who were prescribed antipsychotics had some monitoring done, of the 1,538 prescriptions for antipsychotics (new and renewal) identified, 847 (55%) were considered unmonitored. Having other bloodwork done was significantly associated with higher odds of testing for hyperlipidemia or diabetes (OR=1.45, 95% CI=1.37, 1.56) but not with other factors assessed.

Most autistic youth prescribed antipsychotics in this cohort underwent some monitoring for hyperlipidemia and diabetes but not at a level consistent with guidelines. Many autistic youth not prescribed antipsychotics did not receive testing for hyperlipidemia or diabetes. Providers should consider adding lipid and diabetes testing to other bloodwork, because this was positively associated with monitoring in this analysis.