Dual diagnosis of type 1 diabetes mellitus and attention deficit hyperactivity disorder.

BACKGROUND Data regarding glycemic control in children and adolescents with a dual diagnosis of type 1 diabetes mellitus (T1DM) and attention-deficit/hyperactivity disorder (ADHD) are limited. OBJECTIVE To compare various aspects of diabetes control among youth with T1DM, between those with and without ADHD. METHODS In this cross-sectional study of youth with T1DM, 39 had ADHD (mean age 14.1±2.8 years) and 82 did not (control group, mean age 12.6±3.3 years). Health-related quality of life was assessed by a Diabetes Quality of Life (DQOL) questionnaire submitted to their parents. Glycemic data were downloaded from glucometers, pumps, and continuous glucose monitoring systems. HbA1c levels, hospitalizations, and severe hypoglycemic and diabetes ketoacidosis events were retrieved from the medical files. RESULTS Compared to the control group mean HbA1c level of the ADHD group was higher: 8.3±1.1% versus 7.7±1.0% (p=0.005) and the percent of time that glucose level was in the target range (70-180 mg/dl) was lower: 48±17% versus 59±14% (p=0.006). Mean glucose and glucose variability were higher in the ADHD group. Youth with ADHD who were not pharmacologically treated had worse HbA1c and more hospitalizations than those who were treated. DQOL did not differ between the control group, the treated ADHD group, and the untreated ADHD-Group. CONCLUSIONS Dual diagnosis of T1DM and ADHD during childhood leads to worse diabetes control, which is more pronounced in the context of untreated ADHD. Healthcare providers should be aware of the difficulties facing youth with T1DM and ADHD in coping with the current intensive treatment of diabetes. This article is protected by copyright. All rights reserved.