A research suggests that children with a neuropsychiatric disease may be at risk for type 2 diabetes, and vice versa.

The diseases include depression, attention-deficit hyperactivity disorder, autism, developmental delay, schizophrenia, and bipolar disorder.

" Our findings may be important in screening practices for children with either of these conditions," said the study's leader,Lorraine E. Levitt Katz, of The Children's Hospital of Philadelphia. " Obese children with neuropsychiatric conditions should be screened for diabetes, and children with insulin resistance or type 2 diabetes should be screened for psychiatric conditions."

The researchers found that 46 ( 19 percent ) of 237 children at Children's Hospital diagnosed with type 2 diabetes had previously been diagnosed with neuropsychiatric disease ( NPD ).
The retrospective study, the first to report the frequency of NPD in a cohort of children with type 2 diabetes.

" Of the subset of children in our sample with neuropsychiatric disorders, a substantial number were treated with psychiatric medications reported to cause weight gain," said Robert Berkowitz, at Children's Hospital, and senior author of the study. " However, this is not the only factor at work, as not all of the medications cause weight gain. Depression, as well as other neuropsychiatric illnesses, may itself lead to a sedentary lifestyle, which places children at risk for type 2 diabetes."

While this study examined previously diagnosed neuropsychiatric disease, the true frequency of neuropsychiatric conditions in children with type 2 diabetes may be considerably higher, say the researchers. " For some children, diabetes may occur first, and help contribute to depression and other NPDs," Berkowitz added. " Some researchers suspect that both depression and diabetes have a common basis in the neuroendocrine system, and one disease may help to stimulate the other."

Type 2 diabetes, formerly called adult-onset diabetes and still most common in adults, has been increasing sharply among children over the past decade, in parallel with growing numbers of overweight and obese children. Type 2 diabetes has especially been rising among African American adolescents, who comprised a majority of the patients in the current study.

Although the most effective treatment for type 2 diabetes in children is not known, The Children's Hospital of Philadelphia is participating in a national multicenter trial, comparing medication with the effects of lifestyle changes such as diet and increased exercise.

" For most children, a diagnosis of diabetes demands dramatic lifestyle changes," added Katz. " If the child has a neuropsychiatric disease as well, there are additional challenges, which physicians and caregivers need to factor into the child's treatment to achieve the best results."

Source: Children's Hospital of Philadelphia, 2005


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