title: Comorbidity of attention deficit hyperactivity disorder and type 1 diabetes in children and adolescents: Analysis based on the multicentre DPV registry.
abstract: BACKGROUND
  The interaction between type 1 diabetes mellitus (T1DM) and attention deficit hyperactivity disorder (ADHD) in children and adolescents has been studied rarely. We aimed to analyse metabolic control in children and adolescents with both T1DM and ADHD compared to T1DM patients without ADHD.
  
  
  METHODS
  Auxological and treatment data from 56.722 paediatric patients (<20 years) with T1DM in the multicentre DPV (Diabetes Prospective Follow-up Initiative) registry were analysed. T1DM patients with comorbid ADHD were compared to T1DM patients without ADHD using multivariable mixed regression models adjusting for demographic confounders.
  
  
  RESULTS
  We identified 1.608 (2.83%) patients with ADHD, 80.8% were male. Patients with comorbid ADHD suffered twice as often from diabetic ketoacidosis compared to patients without ADHD [10.2; 9.7-10.8 vs [5.4; 5.3-5.4] (P < .0001). We also found significant differences in HbA1c [8.6% (7.3-9.4); 66.7 mmol/mol (56.3-79.4) vs 7.8% (7.0-9.0); 62.1 mmol/mol (53.2-74.7)], insulin dose/kg [0.9 IU/kg (0.7-1.1) vs 0.8 IU/kg (0.7-1.0)], body mass index-standard deviation score (BMI-SDS) [0.2 (-0.5 to 0.8) vs 0.3 (-0.3 to 0.9)], body weight-SDS [0.1 (-0.5 to 0.8) vs 0.3 (0.3 - 0.9)]; (all P < 0.0001), and systolic blood pressure after adjustment [mean: 116.3 vs 117.1 mm Hg)]; (P < 0.005).
  
  
  CONCLUSIONS
  Paediatric patients with ADHD and T1DM showed poor metabolic control compared to T1DM patients without ADHD. Closer cooperation between specialized paediatric diabetes teams and paediatric psychiatry/psychology seems to be necessary to improve diabetes care and metabolic control in this group of patients.
authors: Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany.
authors: Doerte
authors: D
authors: Hilgard
authors: Department of Pediatric and Adolescent Medicine, University of Cologne, Cologne, Germany.|Department of Pediatric and Adolescent Medicine, Elisabeth Hospital Essen, Essen, Germany.
authors: Katja
authors: K
authors: Konrad
authors: Department of Child and Adolescent Psychiatry, Gemeinschaftskrankenhaus, Herdecke, Germany.
authors: Michael
authors: M
authors: Meusers
authors: Department of Pediatrics, Filderklinik, Filderstadt, Germany.
authors: Bela
authors: B
authors: Bartus
authors: Department of Pediatrics, Medical Center Itzehoe, Itzehoe, Germany.
authors: Klaus-Peter
authors: KP
authors: Otto
authors: Catholic Children's Hospital Wilhelmstift, Hamburg, Germany.
authors: Rudolf
authors: R
authors: Lepler
authors: Department of Pediatrics, Medical University of Vienna, Vienna, Austria.
authors: Edith
authors: E
authors: Schober
authors: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
authors: Esther
authors: E
authors: Bollow
authors: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.|German Center for Diabetes Research (DZD), Neuherberg, Germany.
authors: Reinhard W
authors: RW
authors: Holl
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000188:drug therapy; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D016883:Diabetic Ketoacidosis / Q000209:etiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012042:Registries
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D011619:Psychotropic Drugs; C517652:hemoglobin A1c protein, human
keywords: attention deficit hyperactivity disorder; children; diabetic ketoacidosis; glycated haemoglobin (HbA1c); type 1 diabetes mellitus