BACKGROUND Little is known about the impact of cumulative attention-deficit/hyperactivity disorder (ADHD) medication use on the risk of type 2 diabetes (T2D). OBJECTIVE The objective is to examine the association between cumulative use of ADHD medication and risk of incident T2D. METHODS A nested case-control study was conducted in a national cohort of individuals aged 18-70 years with incident ADHD (n=138 778) between 2007 and 2020 through Swedish registers. Individuals with incident T2D after ADHD were selected as cases (n=2355) and matched with up to five controls (n=11 681) on age at baseline, sex and birth year. Conditional logistic regression models examined the association between cumulative duration of ADHD medication use and T2D. FINDINGS Compared with no use, a decreased risk of T2D was observed for those on cumulative use of ADHD medications up to 3 years (ORs: 03 years, 0.97 (95% CI, 0.84 to 1.12)). When investigating medication types separately, methylphenidate showed results similar to main analyses, lisdexamfetamine showed no association with T2D, whereas long-term (>3 years) use of atomoxetine was associated with an increased risk of T2D (OR: 1.44 (95% CI, 1.01 to 2.04)). CONCLUSION Cumulative use of ADHD medication does not increase the risk for T2D, with the exception of long-term use of atomoxetine. CLINICAL IMPLICATIONS Findings suggest that clinicians should be aware of the potential risk of T2D associated with the cumulative use of atomoxetine among patients with ADHD; however, further replication is strongly needed.

中文翻译：

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成人 ADHD 药物累积使用和 2 型糖尿病风险：瑞典注册研究。


背景 人们对于累积性注意力缺陷/多动障碍 (ADHD) 药物使用对 2 型糖尿病 (T2D) 风险的影响知之甚少。目的 目的是检查 ADHD 药物的累积使用与 T2D 事件风险之间的关联。方法 通过瑞典登记册，对 2007 年至 2020 年间患有 ADHD 的 18-70 岁全国人群（n=138 778）进行了一项巢式病例对照研究。选择 ADHD 后发生 T2D 的个体作为病例 (n=2355)，并与最多 5 名对照者 (n=11 681) 在基线年龄、性别和出生年份上进行匹配。条件逻辑回归模型检查了 ADHD 药物使用的累积持续时间与 T2D 之间的关联。结果 与不使用相比，累积使用 ADHD 药物长达 3 年的患者患 T2D 的风险降低（OR：03 年，0.97（95% CI，0.84 至 1.12））。当单独调查药物类型时，哌醋甲酯显示的结果与主要分析相似，赖右苯丙胺显示与 T2D 无关，而长期（>3 年）使用托莫西汀与 T2D 风险增加相关（OR：1.44（95% CI， 1.01 至 2.04))。结论 除长期使用阿托西汀外，ADHD 药物的累积使用不会增加患 T2D 的风险。临床意义 研究结果表明，临床医生应意识到 ADHD 患者累积使用托莫西汀所带来的 T2D 潜在风险；然而，强烈需要进一步复制。