In pediatric T1D, poor metabolic control predicts psychiatric risk

  • Sildorf SM & al.
  • Diabetes Care
  • 29 Sep 2018

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Children with type 1 diabetes (T1D) and high HbA1c within 2 years of T1D onset have increased risk for psychiatric conditions.
  • Estimated risk of developing a psychiatric disorder within a couple of decades is almost 30%.

Why this matters

  • Findings suggest HbA1c levels are a mediating factor in the association between T1D and increased risk for psychiatric conditions.
  • Authors say their findings suggest that targeting preliminary symptoms immediately and supporting patients in their daily life might help prevent these "reactive" psychiatric conditions.

Key results

  • About 1 in 5 of the children were ultimately diagnosed with at least 1 psychiatric disorder.
  • Diagnosed group had higher average HbA1c (0.22%; 95% CI, 0.15%-0.29%; P<.001 vs no psychiatric disorder and increased risk for diabetic ketoacidosis-related hospitalization ci>
  • Those with neurodevelopmental disorders did not have higher HbA1c levels, but those with reactive psychiatric disorders did (OR, 0.28%; 95% CI, 0.19%-0.37%; P<.001>
  • BMI, severe hypoglycemia not associated with psychiatric disorder risk.

Study design

  • Danish registry study, data for 4725 children with T1D.
  • Association of age at T1D onset, HbA1c levels assessed.
  • Funding: Ronald McDonald Children’s Foundation; others.

Limitations

  • No data on psychiatric remission/recovery, or on treatment, QoL, other potentially influential factors.

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