Stine M Sildorf1, Nina Breinegaard2, Emilie B Lindkvist1, Janne S Tolstrup3, Kirsten A Boisen4, Grete K Teilmann5,6, Anne Mette Skovgaard3,7, Jannet Svensson8,6. 1. Department of Pediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark. 2. Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark. 3. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 4. Center of Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. 5. Department of Pediatrics and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Denmark. 6. Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. 7. Institute of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. 8. Department of Pediatrics and Adolescent Medicine, Herlev Hospital, Herlev, Denmark jannet.svensson@regionh.dk.
Abstract
OBJECTIVE: Type 1 diabetes is associated with an increased risk of psychiatric morbidities. We investigated predictors and diabetes outcomes in a pediatric population with and without psychiatric comorbidities. RESEARCH DESIGN AND METHODS: Data from the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids) and National Patient Register were collected (1996-2015) for this population-based study. We used Kaplan-Meier plots to investigate whether age at type 1 diabetes onset and average glycated hemoglobin (HbA1c) levels during the first 2 years after onset of type 1 diabetes (excluding HbA1c at debut) were associated with the risk of being diagnosed with a psychiatric disorder. Mixed-effects linear and logistic regression models were used to analyze HbA1c, BMI, severe hypoglycemia (SH), or ketoacidosis as outcomes, with psychiatric comorbidities as explanatory factor. RESULTS: Among 4,725 children and adolescents with type 1 diabetes identified in both registers, 1,035 were diagnosed with at least one psychiatric disorder. High average HbA1c levels during the first 2 years predicted higher risk of psychiatric diagnoses. Patients with psychiatric comorbidity had higher HbA1c levels (0.22% [95% CI 0.15; 0.29]; 2.40 mmol/mol [1.62; 3.18]; P < 0.001) and an increased risk of hospitalization with diabetic ketoacidosis (1.80 [1.18; 2.76]; P = 0.006). We found no associations with BMI or SH. CONCLUSIONS: High average HbA1c levels during the first 2 years after onset of type 1 diabetes might indicate later psychiatric comorbidities. Psychiatric comorbidity in children and adolescents with type 1 diabetes increases the risk of poor metabolic outcomes. Early focus on the disease burden might improve outcomes.
OBJECTIVE:Type 1 diabetes is associated with an increased risk of psychiatric morbidities. We investigated predictors and diabetes outcomes in a pediatric population with and without psychiatric comorbidities. RESEARCH DESIGN AND METHODS: Data from the Danish Registry of Childhood and Adolescent Diabetes (DanDiabKids) and National Patient Register were collected (1996-2015) for this population-based study. We used Kaplan-Meier plots to investigate whether age at type 1 diabetes onset and average glycated hemoglobin (HbA1c) levels during the first 2 years after onset of type 1 diabetes (excluding HbA1c at debut) were associated with the risk of being diagnosed with a psychiatric disorder. Mixed-effects linear and logistic regression models were used to analyze HbA1c, BMI, severe hypoglycemia (SH), or ketoacidosis as outcomes, with psychiatric comorbidities as explanatory factor. RESULTS: Among 4,725 children and adolescents with type 1 diabetes identified in both registers, 1,035 were diagnosed with at least one psychiatric disorder. High average HbA1c levels during the first 2 years predicted higher risk of psychiatric diagnoses. Patients with psychiatric comorbidity had higher HbA1c levels (0.22% [95% CI 0.15; 0.29]; 2.40 mmol/mol [1.62; 3.18]; P < 0.001) and an increased risk of hospitalization with diabetic ketoacidosis (1.80 [1.18; 2.76]; P = 0.006). We found no associations with BMI or SH. CONCLUSIONS: High average HbA1c levels during the first 2 years after onset of type 1 diabetes might indicate later psychiatric comorbidities. Psychiatric comorbidity in children and adolescents with type 1 diabetes increases the risk of poor metabolic outcomes. Early focus on the disease burden might improve outcomes.
Authors: Subhankar Chatterjee; Ajay K Bakhla; Payel Biswas; Souvik Singha; Souvik Dubey; Chandra Bhushan Sharma; Subhankar Chowdhury Journal: J Family Med Prim Care Date: 2020-02-28
Authors: Shengxin Liu; Ralf Kuja-Halkola; Henrik Larsson; Paul Lichtenstein; Jonas F Ludvigsson; Ann-Marie Svensson; Soffia Gudbjörnsdottir; Magnus Tideman; Eva Serlachius; Agnieszka Butwicka Journal: Diabetologia Date: 2021-01-16 Impact factor: 10.122
Authors: A Geirhos; M Domhardt; F Lunkenheimer; S Temming; R W Holl; K Minden; P Warschburger; T Meissner; A S Mueller-Stierlin; H Baumeister Journal: BMC Pediatr Date: 2022-01-29 Impact factor: 2.125
Authors: Kelly R Bergmann; Amanda Nickel; Matt Hall; Gretchen Cutler; M Jennifer Abuzzahab; Brianna Bretscher; Shea Lammers; Dave Watson; Gabrielle Z Hester Journal: JAMA Netw Open Date: 2022-05-02