Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Centre for Clinical Research Sörmland, Eskilstuna/Uppsala University, Uppsala, Sweden.
Pediatr Diabetes. 2018 Jun;19(4):816-822. doi: 10.1111/pedi.12651. Epub 2018 Mar 24.
Managing modern diabetes treatment requires efficient executive functions. Patients with attention-deficit/hyperactivity disorder (ADHD) and type 1 diabetes have poor metabolic control and present with ketoacidosis more often than patients without ADHD.
To assess whether patients with type 1 diabetes and with indications of executive problems met criteria for ADHD, and to investigate whether these patients had difficulties achieving metabolic control.
In a hospital-based study, including 3 pediatric departments at hospitals in Stockholm and Uppsala, Sweden, questionnaires regarding executive problems had been filled out by 12- to 18-year-old patients with type 1 diabetes and their parents. Out of 166 patients with completed questionnaires, 49 were selected for a clinical study due to reported executive problems/ADHD symptoms. However, 7 already had a diagnosis of ADHD, 21 denied follow-up, 8 did not respond, leaving 13 adolescents for the clinical assessment.
Of the clinically assessed adolescents, 9 (6 girls) met criteria for ADHD. Patients who did not respond to the follow-up and patients who were diagnosed with ADHD within the study, showed to a larger extent than the other study groups high HbA1c levels (>70 mmol/mol, 8,6%). HbA1c >70 mmol/mol (8.6%) was associated with diagnosed ADHD (prior to or within the study), odds ratio 2.96 (95% confidence interval 1.02-8.60).
Patients with type 1 diabetes and poor metabolic control should be assessed with regard to ADHD. There is a need for paying special attention to girls with poor metabolic control.
管理现代糖尿病治疗需要高效的执行功能。患有注意力缺陷/多动障碍（ADHD）和 1 型糖尿病的患者代谢控制较差，且更容易发生酮症酸中毒，比没有 ADHD 的患者更为常见。
评估是否存在执行问题的 1 型糖尿病患者符合 ADHD 的诊断标准，并研究这些患者在实现代谢控制方面是否存在困难。
在一项基于医院的研究中，包括瑞典斯德哥尔摩和乌普萨拉的 3 家儿科医院，12 至 18 岁的 1 型糖尿病患者及其父母填写了关于执行问题的问卷。在完成问卷的 166 名患者中，由于报告的执行问题/ADHD 症状，有 49 名被选入临床研究。然而，其中 7 名已经被诊断为 ADHD，21 名拒绝随访，8 名未回复，因此只有 13 名青少年接受了临床评估。
在接受临床评估的青少年中，有 9 名（6 名女孩）符合 ADHD 的诊断标准。那些未回复随访的患者和在研究中被诊断为 ADHD 的患者，与其他研究组相比，糖化血红蛋白（HbA1c）水平（>70mmol/mol，8.6%）更高。HbA1c>70mmol/mol（8.6%）与诊断为 ADHD（之前或在研究期间）相关，优势比为 2.96（95%置信区间为 1.02-8.60）。
代谢控制较差的 1 型糖尿病患者应评估是否患有 ADHD。需要特别关注代谢控制较差的女孩。
