IMPE Abstracts

Introduction: One of the pillars of type 1 diabetes mellitus (T1DM) treatment is nutritional management with carbohydrate counting (CC), which requires constant control of food consumed, learning mathematical reasoning, or using mobile apps to calculate the amount of insulin administered before meals. CC can be hampered by Attention Deficit Disorder and Hyperactivity Disorder (ADHD), characterized in childhood by hyperactivity, impulsivity, and inattention.

Aim: To evaluate the prevalence of ADHD in patients with T1DM according to the use of CC in nutritional management.

Methods: A cross-sectional study was carried out at the pediatric endocrinology outpatient clinic at a tertiary hospital in 2022 with adolescents with T1DM. The study population included 32 patients (18 using and 14 not using CC). Clinical and laboratory data were collected, and the assessment of ADHD was performed using the SNAP-IV Rating scale as a screening instrument.

Results: The median age was 14,1 [10,9;17,9]. Sixteen (50%) patients were female, and 16 (50%) were male. Regarding carbohydrate counting, 56.3% performed CC, while 43.7% used fixed insulin doses. Of the studied patients, ten (31.3%) scored on the SNAP-IV rating scale. Seven (21,9%) scored at least six items marked "A LOT" or "TOO MANY" in questions 1 to 9 in the SNAP-IV, which indicated more symptoms of inattention than expected in a child or adolescent. In contrast, four (12.5%) scored at least six items marked as "A LOT" or "TOO MANY" in questions 10 to 18 on SNAP-IV, which indicated more symptoms of hyperactivity and impulsivity than expected in a child or adolescent. There was no significant difference in the prevalence of ADHD symptoms between groups that performed and did not perform CC (27.8% vs. 35.7%; P=0.712). Also, 84.4% of the patients have glycated hemoglobin above 8%. However, there was no significant difference in the average glycated hemoglobin between patients that scored or not on the SNAP-IV rating scale (P=0.329)

Conclusion: A high prevalence in the ADHD score was observed through the SNAP-IV rating scale in the studied cohort. Although there was no difference in the prevalence of ADHD between the groups that do or do not CC, it is necessary to investigate this comorbidity to improve adherence in nutritional management and consequent glycemic control.