Data regarding the effect of CGM use on glycemic control in children with a dual diagnosis of type 1 diabetes mellitus (T1DM) and attention-deficit/hyperactivity disorder (ADHD) are limited. The aims of the study were to compare CGM use and various aspects of diabetes control among children with T1DM in the following groups: those without ADHD, those with medically treated ADHD and those with untreated ADHD.
In this cross-sectional study of 111 children with T1DM, 15 had untreated ADHD, 12 had treated ADHD and 84 did not have ADHD (Control Group). Glycemic data were downloaded from glucometers, pumps, and continuous glucose monitoring systems. HbA1c levels, hospitalizations, severe hypoglycemic and diabetes ketoacidosis events were retrieved from the medical files.
Untreated ADHD patients used CGM significantly less than treated ADHD and Control Groups (27%, 75%, 58% respectively), although most of them had approval to use CGMs. Mean HbA1c levels were highest in the untreated ADHD group: 8.6±1.2%, 8.3±1.1%, and 7.8±1.0% respectively (p=0.009). Time in range (70-180 mg/dl) was lower and mean glucose was higher in this group. Untreated ADHD had more hospitalizations compared to the treated ADHD and the control group.
In this study untreated ADHD patients with T1DM used CGM less than treated ADHD patients and had worse diabetes control. Healthcare providers should be aware of the difficulties facing children with T1DM and ADHD in coping with the current intensive treatment of diabetes and encourage the use of advanced technology in those patients.