2219-P: Risk of Young-Onset Diabetes in Autism Spectrum Disorder: Data from the Korean National Health Insurance Service

Introduction and Objective: This nationwide cohort study investigated the risk of young-onset type 1 diabetes (T1D) and type 2 diabetes (T2D) in children and adolescents with autism spectrum disorder (ASD) in South Korea. Methods: Utilizing data from the National Health Insurance Service (NHIS), 21,679 participants with ASD aged ≤20 years were compared with 65,037 age- and sex-matched controls. Cox regression models were used to assess hazard ratios (HRs) for diabetes incidence. Results: The incidence of diabetes in the ASD group was significantly higher than in the control group, with adjusted HRs of 3.09 (95% CI 1.64-5.81) for T1D and 3.62 (95% CI 3.07-4.28) for T2D. Subgroup analyses revealed an increased risk of T2D in younger age groups with ASD, with the highest HR observed in children enrolled at age < 5 years. Higher-income quintiles and urban residence were also associated with a greater risk of T2D in participants with ASD. The increased risk of diabetes was evident even among antipsychotic non-users with ASD. Conclusion: These findings highlight the need for targeted interventions and further research to reduce the burden of diabetes and improve health outcomes in youth with ASD, particularly in Asian populations.