Objective: To assess the interactions between Attention Deficit Hyperactivity Disorder (ADHD) and Type 1 Diabetes Mellitus (T1DM) including diabetes outcomes and patients` general health status in children and adolecents.
Methods: Primary care and hospital records of patients aged 5-18 years old with T1DM were analyzed, using the Leumit Health Services (LHS) database. The diabetic control and general health of patients with T1DM and ADHD diagnoses were compared with patients with T1DM alone, in a cross-sectional study. The ADHD group included patients with ADHD diagnosis that purchased at least 3 prescriptions of Anatomical-Therapeutic-Chemical (ATC code N06B). Parameters including demographic, clinical and laboratory data were collected and assessed.
Results: The study included 230 T1DM patients, of them 24 had ADHD (10.4%). Twenty of 24 ADHD patients (83.3%) had HbA1C of 9% and higher vs. 87/206 (43.3%) of patients with diabetes alone (p<0.05). The ADHD group had significantly higher annual emergency room admissions (15/24(62.5%) vs. 77/201(37.4%)), annual hospitalization rates (18/24 (75%) vs. 78/206 (37.9%)) and longer hospitalization stay (mean 2.21 days vs. 0.65 days). The total medical annual costs per patient, were as twice as high in the ADHD group, all statistically significant (p<0.05). In multivariate analysis, these unfavorable outcomes for the ADHD patients` group were preserved.
Conclusion: In this study, having ADHD and T1DM comorbidity was associated with a higher complications rate and poorer diabetes control, in comparison to patients with T1DM alone. Although further research is needed, it appears that this group requires special care and attention of the medical staff.
