SYSTEMATIC REVIEW


The Prevalence of Diabetes in Autistic Persons: A Systematic Review



Samuel Tromans1, 2, *, Guiqing Yao1, Regi Alexander3, 4, Elizabeta Mukaetova-Ladinska2, 5, Reza Kiani1, 2, Mohammed Al-Uzri1, 2, Verity Chester4, 6, Richard Carr2, Zoe Morgan1, Elpida Vounzoulaki7, Traolach Brugha1, 2
1 Department of Health Sciences, University of Leicester, Leicester, United Kingdom
2 Leicestershire Partnership NHS Trust, Leicester, United Kingdom
3 Department of Psychiatry, University of Hertfordshire, Hatfield, United Kingdom
4 Hertfordshire Partnership University NHS Foundation Trust, Hatfield, United Kingdom
5 Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, United Kingdom
6 Norwich Medical School, University of East Anglia, Norwich, United Kingdom
7 Diabetes Research Centre, University of Leicester, Leicester, United Kingdom


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Creative Commons License
© 2020 Tromans et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Health Sciences, University of Leicester, Leicester, United Kingdom; Tel: 0116 295 5098; Fax: 0116 295 7250; E-mail: sjt56@leicester.ac.uk


Abstract

Background:

It has been proposed that autistic individuals are at an increased risk of type 1 and type 2 diabetes. Improved understanding of diabetes prevalence in autistic persons will help inform resource allocation for diabetes-related public health measures for this patient group.

Objective:

To conduct a systematic review of published literature pertaining to type 1 and type 2 diabetes prevalence in autistic individuals, including comparison with their non-autistic peers.

Methods:

Eligibility criteria included studies investigating the prevalence of diabetes in autistic individuals, as well as having been published in the English language. A systematic search of online databases (MEDLINE, PsycINFO, CINAHL, EMBASE and PubMed) was conducted on 4th April 2020. Additional approaches included the ancestry method, grey literature searches and expert consultation. Studies were qualitatively analysed with reporting quality appraised.

Results:

19 eligible studies were identified, 7 of which provided type-specific diabetes prevalence data. Of 15 studies that included a non-autistic control group, 9 reported a higher diabetes prevalence among autistic persons, with a statistically significant difference in 4 studies. Studies demonstrating a higher diabetes prevalence in autistic groups had higher average study population sizes and reporting quality ratings.

Conclusion:

It is uncertain whether diabetes is significantly more prevalent in autistic persons relative to their non-autistic peers, though larger studies suggest a trend in this direction. Nevertheless, diabetes is a significant public health issue for the autistic community, which may require a tailored approach for identification and management. Prospero database registration number: CRD42019122176.

Keywords: Autism, Asperger, Psychiatric, Diabetes, Epidemiology, Systematic review.