Autism spectrum disorder (Autism) is a condition that affects the way some people think, feel, and behave. People with Autism may be more likely to be overweight than the general population and may be more likely to develop other related conditions like diabetes. Diabetes is an illness that means your body does not use sugar normally and there are two types: insulin-dependent (type 1) and non-insulin-dependent (type 2). The NHS Long Term Plan aims to improve the health of people with Autism, but there are gaps in our understanding of the risks related to conditions like diabetes.
We will use CPRD to compare diabetes in Autism to the general population. We will look at how diabetes is different depending on people’s body fatness, how males and females differ, their age and look at how common the different types of diabetes are. We will investigate how having an intellectual disability diagnosis and Autism together, and being on medication for mental health conditions, might affect how common diabetes is in Autism. We will look at how well people with diabetes and autism are cared for and investigate what kind of complications they get (diabetes can cause problems like with your kidneys, feet and eyes). Finally, we will look at eating disorders which are common in Autism and whether these are linked to diabetes.
By improving understanding of diabetes in Autism we can help the NHS implement their plans to improve the health of people with Autism so they can live healthier lives.
People with Autism spectrum disorder (ASD) are at higher risk of developing medical, neurologic, and psychiatric morbidities than the general population. Rates of obesity and diabetes have been suggested to be higher in ASD in some studies. A key aim of the NHS Long Term Plan is to improve health outcomes in ASD in the context of health disparities and unmet needs currently present. We will use a matched-cohort design to address current gaps in the literature relating to the risk of diabetes in ASD across demographic variables and complications related to diabetes.
People ever diagnosed with ASD will be identified from CPRD Aurum and GOLD databases and matched to general population controls using a 1:4 ratio on sex, age and GP practice. We will examine incidence of diabetes by body mass index, sex and across the lifespan in ASD compared to the general population, explore potential differences in rates of type 1 and type 2 diabetes, estimate the impact of an intellectual disability diagnosis and psychotropic medication on diabetes diagnosis, evaluate quality of care measures including intermediate outcomes of blood pressure and blood glucose control, investigate complications associated with diabetes and evaluate the prevalence of eating disorders and whether these are associated with diabetes since eating disorders are common in ASD and might dispose some people to be at higher risk of diabetes. Our main outcomes will include incidence of diabetes (type 1 and type 2); ophthalmic, neurological, renal and macrovascular complications associated with diabetes, quality of care measures and rates of eating disorders. Linked data will be employed to estimate deprivation related inequalities in ASD and diabetes.
These analyses will provide new insights into diabetes in ASD and help to understand the unique health needs of people with ASD to inform NHS policies to address health inequalities.
Incidence of diabetes mellitus (type 1 and type 2); ophthalmic, neurological, renal and macrovascular complications associated with diabetes (retinopathy, neuropathy, onset of microalbuminuria and chronic kidney disease, stroke, ischaemic heart disease); quality of care measures using a combination of outcome measures from the Quality and Outcomes Framework (QOF) Indicators, the Organisation for Economic Co-operation and Development (OECD) quality of care indicators and NICE guidelines. Rates of eating disorders (e.g. anorexia nervosa, bulimia nervosa, binge-eating disorder).
Asaad Baksh - Chief Investigator - King's College London (KCL)
Asaad Baksh - Corresponding Applicant - King's College London (KCL)
Andre Strydom - Collaborator - King's College London (KCL)
Martin Gulliford - Collaborator - King's College London (KCL)
Practice Level Index of Multiple Deprivation