Excessive HbA1c in kind 1 diabetes linked to elevated threat for neurodevelopment issues

0
465

March 17, 2021

2 min read

Source / information

Published by:

Disclosure:
Liu does not report any relevant financial information. In the study you will find a list of all relevant financial information from all other authors.

ADD SUBJECT TO EMAIL ALARMS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

Back to Healio

Children with type 1 diabetes are at increased risk of developing neurodevelopmental disorders, according to a study published in Diabetologia, whereas children with high HbA1c levels are at higher risk.

Shengxin Liu

“Diabetes teams should be aware of the relationship between poor blood sugar control in type 1 diabetes and an increased risk of neurodevelopmental disorders.” Shengxin Liu, MBBS, MSc, A graduate student in the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet in Solna, Sweden told Healio. “Children and adolescents with self-management difficulties, sub-optimal glycemic control, and unexplained academic problems should receive an assessment for co-morbid neurodevelopmental disorders. Children with type 1 diabetes and co-morbid neurodevelopmental disorders should receive psychosocial interventions, preferably in an interdisciplinary setting involving the diabetes team and professionals with experience in neurodevelopmental disorders. “

Type 1 diabetes increases the risk of developing neurodevelopmental disorder in children. The data were provided by Liu S et al. Diabetologia. 2021; doi: 10.1007 / s00125-020-05372-5.

Liu and colleagues conducted a population-based cohort study using data from health registries from 1973 to 2013. Individuals with type 1 diabetes in childhood who were born in Sweden after 1973 were identified from the SWEDIABKIDS database and the Swedish diabetes registry. Participants with an HbA1c measurement within one year of their diagnosis of diabetes were included. Each child with diabetes was randomly compared by gender, year of birth and country of birth with 10 people without diabetes from the Swedish general population register. Neurodevelopmental disorders were identified from the National Patient Register and Clinical Databases for Mental Health Services for Children and Adolescents, the Habilitation Register and the Halmstad University Register of Students with Intellectual Disabilities.

The researchers included 8,430 people with type 1 diabetes diagnosed before age 18 and 84,300 matching reference people in the study. During a median follow-up of 5.6 years, 4.7% of the diabetes group and 3.6% of the reference persons received at least one diagnosis of a neurodevelopmental disorder. After adjusting for covariates, childhood type 1 diabetes was at a higher risk for neurodevelopmental disorders (adjusted HR = 1.31; 95% CI, 1.18-1.46), ADHD (aHR = 1.29; 95% CI, 1.14-1.46). and autism spectrum disorders (aHR = 1.31; 95% CI, 1.04-1.65) compared to the reference group. Children with diabetes and a mean HbA1c of less than 7.5% showed no increased risk of a neurodevelopmental disorder, while a higher risk for children with HbA1c between 7.5% and 8.6% was found (aHR = 1.22; 95% CI, 1.05-) 1.43) and HbA1c greater than 8.6% (aHR = 1.9; 95% CI, 1.51-2.37) compared to the general population.

Compared to people in the diabetes group with an HbA1c of less than 7.5%, people with an HbA1c of 7.5% to 8.6% (aHR = 1.64; 95% CI, 1.22-2.21 ) and an HbA1c greater than 8.6% (aHR =) 3.71; 95% CI, 2.75-5.02) had an increased risk of developing a neurodevelopmental disorder. There was also an increased risk of ADHD in the subgroups with HbA1c from 7.5% to 8.6% (aHR = 1.73; 95% CI, 1.21-2.46) and HbA1c greater than 8.6 % (aHR = 4.16; 95% CI, 2.92-5.94)) compared to the lowest HbA1c group. The risk of autism spectrum disorders and intellectual disability was not increased with an HbA1c between 7.5% and 8.6%, but children with an HbA1c greater than 8.6% were at increased risk for autism spectrum disorders (aHR = 2.84; 95% CI, 1.52-) 5.28) and intellectual disability (aHR = 3.93; 95% CI, 1.38-11.22).

Liu said future longitudinal studies are needed to assess a wider range of diabetes-related factors and better analyze the association between neurodevelopmental disorders and type 1 diabetes.

“To evaluate the effectiveness of neurodevelopmental screening for type 1 diabetes and therapeutic strategies in children with both diseases, research that integrates the pediatric mental health service and diabetes care is needed,” Liu said.

For more informations:

Shengxin Liu, MBBS, MSccan be reached at shengxin.liu@ki.se.

ADD SUBJECT TO EMAIL ALARMS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . “data-action =” subscribe “> subscribe

We could not process your request. Please try again later. If you continue to have this problem, please contact customerservice@slackinc.com.

Back to Healio