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Autistic children and type 1 diabetes

Autism will affect each child and their type 1 diabetes differently. We run down the main ways that being autistic can affect children with T1D and what to do.
Content last reviewed and updated: 30.01.2025

Young girl sat in chair with pencil resting on chin

01

What is autism?

Autism Spectrum Condition (ASC) affects individuals differently. Autistic people can experience a different understanding and style of communication, a need for certainty, sensory processing differences, and an intense and passionate approach to hobbies and interests. They can also be good at seeing details and patterns.

02

Is type 1 diabetes more common in autistic children?

There isn’t much research into autism and type 1, but there’s currently no suggestion that autism and type 1 diabetes are related. However, autism might be underdiagnosed in people living with type 1 and some autistic behaviours can be wrongly attributed to issues relating to type 1.

03

How do I manage my child’s need for certainty?

Autistic children have a need for certainty and lack of certainty may cause anxiety. Autistic children may struggle with changes to how their type 1 is managed. They may find it difficult when they have changes to their insulin dosage, changing technologies such as moving from injections to an insulin pump, or from making recommended dietary changes.

Autistic children may become more frustrated than neurotypical children when things do not go to plan. If your child has a rigid thinking style, it helps to explain that type 1 can be unpredictable. Type 1 is complex and doing the same thing every time doesn’t always lead to the same result. Rigid thinking can lead to heightened feelings of frustration. These feelings can be internalised by autistic children, which can lead to lower self-esteem.

Learning a lot about type 1 and hearing from other autistic people living with it can help autistic children. Think about using alternative communication styles such as visual cues. Autistic people are known to have a weaker auditory channel which can make verbal communication the least effective form. They tend to have enhanced visual perception however, meaning that things like images, diagrams, visual supports and social stories can be particularly helpful.

04

How do I help my child and their sensory issues?

Autistic people can be over- or under-sensitive to sensory stimulus like sound, sight, taste, touch and smell. This can affect an autistic person living with T1D. Injecting or wearing tech may be painful, or alarms on continuous glucose monitors (CGM) may trigger sensitivity to sound. Speak to your child’s Diabetes Healthcare Team about any how to manage any issues and see our tips for using tech with an autistic child.

Differences with interoception can also interfere with type 1 management. Interoception is the internal sense we have of our body. With autistic children with type 1, it can affect how they recognise both high and low blood glucose. If your autistic child also struggles with communicating their feelings, they find it difficult to both recognise and communicate how their body feels (this is known as alexithymia).

A continuous glucose monitor uses alarms to alert your child, and the people around them, when their glucose levels are high or low. With most CGMs you can also get their readings sent to your phone, or the phones of other caregivers. There are also tools like Dexcom Follow which allows you to share your child’s data.

You can also practice routines and ‘rules’ of who your child should go to and what they should say if their glucose readings are going high or low. Social stories are a good way to help frame what’s happening and what your child needs to do. At school, these aspects of your child’s type 1 diabetes care should be included in your child’s individual healthcare plan.

05

What if my child has a fear of needles?

Autistic children can often struggle with cannula or needle phobia. Speak to your Diabetes Healthcare team about getting support from a specialist diabetes paediatric psychologist to help with this.

06

06 How do I manage my child’s preference for routine?

Autistic children and young people have a strong preference for order and routine and this can be a significant strength for those also living with type 1. For example, wanting the same meals at the same times can make type 1 a bit more predictable when carb counting.

There is some evidence that autistic children have lower HbA1c levels than neurotypical children due to this thinking style. However, when things become disorderly or unorganised, autistic children can become overwhelmed or distressed. It’s helpful to have a plan in place for when things don’t go as expected. Planning what to do with ‘if… then…’ statements can help (if this happens, then we do this). Setting realistic expectations is also important. For example, when children go through puberty, fluctuating hormone levels can make type 1 management more unpredictable. Explaining the role of hormones and how they affect blood glucose can help your child accept this unpredictability.

07

How do I manage autistic meltdowns, shutdowns and burn out with my child’s T1D?

When an autistic person is struggling to process too much information at one time, this can lead to feelings of high anxiety and overwhelm. These feelings can result in changes of behaviour that are often called ‘meltdowns’ or ‘shutdowns.’

Some autistic people and type 1 have reported that high and low blood glucose levels can add to sensory stimuli that cause meltdowns and shutdowns. Fluctuations in blood glucose levels can also reduce an autistic person’s tolerance for other sensory inputs.

Meltdowns and shutdowns can be challenging as your child will be unable to engage with their type 1 diabetes during a meltdown or shutdown. Newer technologies such as hybrid closed loop systems, which automate insulin based on CGM readings, can help in these situations.

Many children show signs before going into a meltdown or shutdown. Take note of the behaviours and triggers that lead into a meltdown or shutdown, so that you can get your child to a more comfortable environment. This might be a calming space in the house where your child can engage with soothing sensory activities.

08

How do I manage T1D around what my autistic child likes to eat?

Food can be challenging area for autistic children with type 1. Autistic children can have very strong aversions to particular foods or need their food presented in a particular way. This can make providing a balanced diet for autistic children difficult. However, their preference for sameness can also be a strength in terms of carbohydrate counting. It can be difficult finding a hypo treatment for autistic children, but there are now many options available, from quick acting juice shots to sweets to gels.

Sensory issues can lead to eating disorders and disordered eating in autistic people, as well as differences in interoception (how someone feels their own body) which can make it difficult to judge what to eat. If you are concerned about your child’s eating and type 1, speak to your Diabetes Healthcare Team as soon as possible and find out more about type 1 and disordered eating.

Working with a specialist dietician who can advise on nutrition is important. If your child is very restricted on what they want to eat, there’s potentially another issue that needs addressing, such as avoidant restrictive food intake disorder (ARFID).

09

How to manage the ups and downs of your child’s pattern recognition skills

Some autistic children are very skilled in recognising patterns. This can be useful for spotting trends in blood sugar, especially if the child is wearing a CGM. However, autistic children often have a strong sense of what ‘should’ be, can be very literal and rule orientated. If glucose readings are different from the pattern they expect, this can be distressing.

At the same time, many autistic children want to understand why things are happening and have a stronger sense of logic. This can be a strength if you can engage your child in learning about type 1. It may even become a passion or specialism!

This content was created by Dr Jacq Allan, Psychologist: Children’s Diabetes Team. It has been reviewed by the National Autistic Society.

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