Risk of Developing Type 2 Diabetes in Adolescents and Young Adults With Autism Spectrum Disorder: A Nationwide Longitudinal Study

Abstract

OBJECTIVE Studies have suggested the association between autism spectrum disorder (ASD) and type 2 diabetes mellitus (DM)–related risk factors, such as obesity and dyslipidemia. However, the association between ASD and type 2 DM remains unknown. RESEARCH DESIGN AND METHODS We used the Taiwan National Health Insurance Research Database for enrolling 6,122 adolescents and young adults with ASD and 24,488 age- and sex-matched control subjects between 2002 and 2009 and monitored them until the end of 2011. Participants who developed type 2 DM during the follow-up period were identified. RESULTS Adolescents (hazard ratio [HR] 2.71 [95% CI 1.64–4.48]) and young adults (HR 5.31 [95% CI 2.85–9.90]) with ASD had a higher risk of developing type 2 DM than those without ASD, after adjustment for demographic data, atypical antipsychotics use, and medical comorbidities. Sensitivity analyses after excluding first year (HR 3.03 [95% CI 2.03–4.51]) and first 3-year (HR 2.62 [95% CI 1.62–4.23]) observation periods were consistent. Short-term (HR 1.97 [95% CI 1.20–3.23]) and long-term (HR 1.64 [95% CI 1.02–2.63]) use of atypical antipsychotics were associated with a higher likelihood of subsequent type 2 DM. CONCLUSIONS Adolescents and young adults with ASD were more likely to develop type 2 DM during the follow-up. In addition, those with ASD using atypical antipsychotics exhibited a high risk. Therefore, further research is necessary to investigate the common pathophysiology of ASD and type 2 DM.