1074-OR: Early-Life Hypoglycemia, Developmental Disorders, Neurodiversity, and Psychiatric Disease: A Real-World Observational Study

Introduction and Objective: Neonatal hypoglycemia is a common complication of maternal diabetes, which usually resolves quickly after birth. However, long-term effects upon neurocognitive function in childhood and adolescence are unknown. We investigated the association between early-life hypoglycemia and developmental disorders, neurological conditions, neurodiversity and psychiatric disease in a large real-world dataset. Methods: Using the US collaborative network within the TriNetX database, we compared cohorts with vs without early-life hypoglycemia (glucose <47 mg/dl, age <1 year) 1:1 propensity-score matched using demographics, preterm gestational age, birthweight and neonatal complications. We investigated the relative rates of various developmental, neurological, neurodiversity and psychiatric outcomes across the two cohorts. Results: After matching, 20,947 individuals were identified in each cohort (mean age 0.00 years; 45.5% female) with up to 20 years follow-up. Individuals with vs without early-life hypoglycemia had higher rates of intellectual disability (HR 2.00 [95% CI 1.75, 2.28]); developmental disorders (1.64 [1.57, 1.70]); visual impairment (1.69 [1.58, 1.80]); speech and language disorders (1.34 [1.27, 1.40]); hearing loss (1.52 [1.44, 1.61]); epilepsy (1.79 [1.66, 1.92]); psychomotor delay (1.81 [1.75, 1.88]); autism (1.39 [1.26, 1.53]); attention deficit hyperactivity disorder (1.10 [1.00, 1.20]); dyspraxia (1.57 [1.47, 1.68]); sleep disorders (1.31 [1.24, 1.38]); and eating disorders (1.27 [1.05, 1.54]). Rates of other neurodiversity and psychiatric outcomes were not significantly different. Conclusion: Early-life hypoglycemia is associated with sensory and intellectual disabilities, developmental and sensory disorders, neurodiversity and eating disorders in childhood and adolescence. Further research is needed to establish causality and to investigate if preventative interventions for early-life hypoglycemia reduce future risk. Disclosure F. Surti: None. J. Goldney: None. M. Davies: Advisory Panel; Current; AbbVie Inc., Amgen Inc., Biomea Fusion, Roche Pharmaceuticals, Regeneron Pharmaceuticals Inc., Daewoong Pharmaceutical. Other - Advisory Panel and Speaker Bureau; Current; Sanofi. Advisory Panel; Current; Zealand Pharma A/S, GlaxoSmithKline plc. Other - Advisory Panel, Speaker Bureau, Grants in support of Trials; Current; AstraZeneca. Other - Consultant/Advisor/Speaker Bureau/Grants in support of Trials; Current; Boehringer Ingelheim International GmbH. Other - Consultant/Advisor/Speaker Bureau; Current; Eli Lilly and Company. Other - Consultant/Advisor/Speaker Bureau/Grants in support of Trials; Current; Novo Nordisk. Speaker's Bureau; Current; Zuellig Pharma Holdings Pte. Ltd. Advisory Panel; Current; EktaH. C. Meek: Research Support; Current; Dexcom, Inc. Funding European Foundation for the Study of Diabetes - Novo Nordisk Foundation Future Leaders’ Award (NNF19SA058974). Diabetes UK.