Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan.
Department of Nephrology, China Medical University Hospital, Taichung, Taiwan.
Pediatr Diabetes. 2019 Mar;20(2):189-196. doi: 10.1111/pedi.12716. Epub 2018 Dec 18.
Data regarding the association between hypoglycemia and attention deficit hyperactivity disorder (ADHD) in children and adolescents with type 1 diabetes mellitus (T1DM) are limited. This study investigated whether hypoglycemia was associated with the risk of ADHD in young people with T1DM.
Children and adolescents with a diagnosis of T1DM were identified from the Longitudinal National Health Insurance Database in Taiwan from 1998 to 2011. Among them who were newly diagnosed with hypoglycemia during 2000 to 2007 were selected for the hypoglycemia cohort. The hypoglycemia diagnosis date was defined as the index date. Those who were diagnosed with ADHD before the index date were excluded. The main outcome was the development of ADHD. In total, 726 participants with hypoglycemia and 2852 participants without hypoglycemia were included in this study.
The overall incidence density of ADHD was markedly increased among cohort with hypoglycemia compared with cohort without hypoglycemia (4.74 vs 1.65 per 1000 person-years), with an adjusted hazard ratio (aHR) of 2.73 (95% confidence interval [CI] = 1.50-4.98). Cohort with hypoglycemia who had experienced a hypoglycemic coma had a significantly higher risk of ADHD (aHR = 6.54, 95% CI = 1.89-22.7) compared with cohort without hypoglycemia.
Hypoglycemia, especially hypoglycemic coma, is significantly associated with a subsequent risk of ADHD in young people with T1DM.
关于 1 型糖尿病（T1DM）儿童和青少年低血糖与注意力缺陷多动障碍（ADHD）之间关联的数据有限。本研究旨在探讨低血糖是否与 T1DM 年轻人患 ADHD 的风险相关。
从台湾 1998 年至 2011 年的纵向国家健康保险数据库中确定了 T1DM 诊断的儿童和青少年。在 2000 年至 2007 年期间新诊断为低血糖的患者中选择低血糖队列。低血糖的诊断日期定义为索引日期。在索引日期之前被诊断患有 ADHD 的患者被排除在外。主要结局是 ADHD 的发展。共有 726 名低血糖患者和 2852 名无低血糖患者纳入本研究。
与无低血糖组相比，低血糖组的 ADHD 总体发生率密度明显增加（4.74 比 1.65/1000 人年），校正后的危险比（aHR）为 2.73（95%置信区间[CI]：1.50-4.98）。与无低血糖组相比，经历低血糖昏迷的低血糖组发生 ADHD 的风险显著更高（aHR=6.54，95%CI=1.89-22.7）。
低血糖，尤其是低血糖昏迷，与 T1DM 年轻人发生 ADHD 的后续风险显著相关。
