Department of Pediatrics, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
Department of Child and Adolescent Psychiatry, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey.
Pediatr Diabetes. 2019 May;20(3):345-352. doi: 10.1111/pedi.12819. Epub 2019 Jan 31.
Psychiatric diagnoses of patients with type 1 diabetes mellitus (T1DM), the severity of attention deficit/hyperactivity disorder (ADHD) symptoms of the patients and their primary caregivers, and the effects of these factors on treatment were investigated.
Sixty-one patients with T1DM were included in the study along with their parents. Psychiatric diagnoses of the patients were determined using a semistructured psychiatric interview, and their depression and ADHD symptom severities were evaluated with self-report scales. The ADHD symptom severities of the parents were evaluated using self-report scales. The relationships among the psychiatric symptoms and the hemoglobin A1c (HbA1c), fasting blood glucose (FBG), and postprandial blood glucose (PBG) levels of the patients were investigated.
HbA1c levels were found to correlate with the hyperactivity levels of children and the number of diagnoses they had. FBG and PBG values of patients diagnosed with ADHD were found to be higher than in those who did not have ADHD. HbA1c, FBG, and PBG values of the patients who had any disruptive behavior disorder were found to be higher than in those who did not. ADHD total scores, gender (being female), having diagnoses of ADHD or depression were found to be predictive of HbA1c levels according to the regression analyses. No relationship between the clinical findings of the children and their parents' ADHD levels was found.
The findings of this study implicate that children with T1DM should be evaluated in terms of ADHD which could have negative effects on the treatment.
调查 1 型糖尿病（T1DM）患者的精神科诊断、患者及其主要照顾者注意力缺陷/多动障碍（ADHD）症状的严重程度，以及这些因素对治疗的影响。
研究纳入 61 例 T1DM 患者及其父母。采用半结构式精神科访谈对患者进行精神科诊断，采用自我报告量表评估其抑郁和 ADHD 症状严重程度。采用自我报告量表评估父母的 ADHD 症状严重程度。调查患者的精神科症状与血红蛋白 A1c（HbA1c）、空腹血糖（FBG）和餐后血糖（PBG）水平之间的关系。
HbA1c 水平与儿童多动水平和诊断数量呈正相关。被诊断为 ADHD 的患者的 FBG 和 PBG 值高于未被诊断为 ADHD 的患者。患有任何破坏性行为障碍的患者的 HbA1c、FBG 和 PBG 值均高于未患有破坏性行为障碍的患者。根据回归分析，ADHD 总分、性别（女性）、ADHD 或抑郁诊断是 HbA1c 水平的预测因素。未发现儿童的临床发现与父母的 ADHD 水平之间存在任何关系。
本研究结果表明，应评估患有 T1DM 的儿童是否存在 ADHD，因为这可能对治疗产生负面影响。
