ADHD and autism appear more common among young people diagnosed with type 2 diabetes

Neurodivergent people, particularly those with autism or ADHD (attention-deficit/hyperactivity disorder), may be more likely to be diagnosed with type 2 diabetes (T2D) at younger ages. An analysis of patient data found a particularly high prevalence of neurodiversity among people diagnosed with T2D before age 20.

The findings are being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy, from September 28–October 2.

With the prevalence of ADHD and autism among those younger than 20 reaching as high as 14% and 5%, respectively, the authors underscore the importance of considering the needs of neurodivergent people when planning clinical services and support for those with early-onset T2D.

“Health systems are failing to fully meet the needs of people living with both early-onset T2D and neurodiversity, both of which are linked to poorer health outcomes,” said lead author Dr. Jonathan Goldney of the University of Leicester Diabetes Research Center and NIHR Biomedical Research Center in Leicester, U.K.

“Neurodivergent people and those living with early-onset T2D are likely to face unique challenges when navigating busy health care environments, communicating with health care professionals, and managing their diabetes.

“Providing health care for T2D in a suitable way for neurodivergent individuals is critical to making health care more accessible for everyone, particularly as more people are being diagnosed with T2D earlier in life.”

Rates of early-onset T2D, defined as diagnosis before age 40, are rising, and the condition is associated with poorer health outcomes. Challenges engaging with health care and the burden of managing diabetes can be compounded by stigma and the competing demands of early adulthood. Being diagnosed with T2D at a younger age also means longer lifetime exposure to the condition, increasing the risk of serious complications and early death.

To better understand this growing and underserved population, researchers examined the prevalence of neurodiversity (ADHD, autism, dyslexia, and dyspraxia) among 4.2 million people newly diagnosed with T2D from the TriNetX US collaborative network between March 2006 and March 2026. The researchers grouped them by age at diagnosis into 10-year age bands.

Each 10-year age group was then matched by age, year of birth, sex, ethnicity and race to people without T2D drawn from a group of 17.1 million, to account for demographic differences between those with and without T2D. In total, 3.4 million matched pairs younger than 80 were included in the analysis.

Overall, among people both with and without T2D, the prevalence of neurodiversity was highest at younger ages and declined rapidly with age, becoming extremely low beyond age 40.

However, both ADHD and autism were consistently more prevalent among people with T2D, with the greatest differences observed at younger ages. For example, ADHD was more than twice as prevalent among people diagnosed with T2D before age 20 as among similarly aged people without T2D (14.4% vs. 6.9%). This difference generally declined with age, with ADHD around 1.4 times more prevalent among people diagnosed with T2D at ages 70–79 (0.25% vs. 0.18%).

Similarly, autism was more than three times as prevalent among people diagnosed with T2D before age 20 as among those without T2D (5.72% vs. 1.79%). The difference was smaller among those diagnosed at ages 70–79, for whom autism was 1.24 times as prevalent. However, the prevalence of autism was extremely low in the 70–79 age group with or without T2D—less than 0.01% in both groups.

Dyslexia and dyspraxia were also more prevalent among younger people. Overall, people with T2D were about twice as likely to have dyslexia as those without T2D, but this difference didn’t appear to vary in an obvious pattern with age.

The authors speculate that several factors may contribute to the association between neurodivergent conditions and T2D, including lower levels of physical activity, sleep difficulties, medication use, mental health conditions and barriers to accessing health care. Factors earlier in life may also play a role. For example, maternal diabetes has been associated with neurodevelopmental outcomes and later cardiometabolic risk in children.

“Our findings by no means suggest that most people with a neurodivergent condition will go on to develop type 2 diabetes,” Goldney said. “However, the higher prevalence of neurodiversity among people diagnosed with T2D earlier in life should be considered when planning services for people with early-onset T2D. Taking neurodiversity into account could help reduce potential barriers to accessing and engaging with health care.”

The authors point out that, although the study was large, its observational design means it cannot establish cause and effect, and the influence of other factors that were not measured cannot be ruled out. The study also relied on anonymized hospital records, which may be prone to errors and are not specifically designed for research.

They note that people with neurodivergent conditions may have more frequent contact with health care professionals, potentially increasing opportunities for a T2D diagnosis and influencing the findings. Additionally, because the study included only people who had attended a hospital, it may not be fully representative of the wider population and could exclude healthier people. This may have affected the prevalence estimates, particularly among younger people without T2D.

The authors add that future studies should explore the factors underlying the association between neurodivergent conditions and T2D, and whether diabetes care that takes neurodiversity into account can improve health outcomes.

Provided by
European Association for the Study of Diabetes

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