1745-0179/20 Send Orders for Reprints to reprints@benthamscience.net 212 DOI: 10.2174/1745017902016010212, 2020, 16, 212-225 Clinical Practice & Epidemiology in Mental Health Content list available at: https://clinical-practice-and-epidemiology-in-mental-health.com SYSTEMATIC REVIEW The Prevalence of Diabetes in Autistic Persons: A Systematic Review Samuel Tromans 1,2,* , Guiqing Yao 1 , Regi Alexander 3,4 , Elizabeta Mukaetova-Ladinska 2,5 , Reza Kiani 1,2 , Mohammed Al- Uzri 1,2 , Verity Chester 4,6 , Richard Carr 2 , Zoe Morgan 1 , Elpida Vounzoulaki 7 and Traolach Brugha 1,2 1 Department of Health Sciences, University of Leicester, Leicester, United Kingdom 2 Leicestershire Partnership NHS Trust, Leicester, United Kingdom 3 Department of Psychiatry, University of Hertfordshire, Hatfield, United Kingdom 4 Hertfordshire Partnership University NHS Foundation Trust, Hatfield, United Kingdom 5 Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, United Kingdom 6 Norwich Medical School, University of East Anglia, Norwich, United Kingdom 7 Diabetes Research Centre, University of Leicester, Leicester, United Kingdom Abstract: Background: It has been proposed that autistic individuals are at an increased risk of type 1 and type 2 diabetes. Improved understanding of diabetes prevalence in autistic persons will help inform resource allocation for diabetes-related public health measures for this patient group. Objective: To conduct a systematic review of published literature pertaining to type 1 and type 2 diabetes prevalence in autistic individuals, including comparison with their non-autistic peers. Methods: Eligibility criteria included studies investigating the prevalence of diabetes in autistic individuals, as well as having been published in the English language. A systematic search of online databases (MEDLINE, PsycINFO, CINAHL, EMBASE and PubMed) was conducted on 4 th April 2020. Additional approaches included the ancestry method, grey literature searches and expert consultation. Studies were qualitatively analysed with reporting quality appraised. Results: 19 eligible studies were identified, 7 of which provided type-specific diabetes prevalence data. Of 15 studies that included a non-autistic control group, 9 reported a higher diabetes prevalence among autistic persons, with a statistically significant difference in 4 studies. Studies demonstrating a higher diabetes prevalence in autistic groups had higher average study population sizes and reporting quality ratings. Conclusion: It is uncertain whether diabetes is significantly more prevalent in autistic persons relative to their non-autistic peers, though larger studies suggest a trend in this direction. Nevertheless, diabetes is a significant public health issue for the autistic community, which may require a tailored approach for identification and management. Prospero database registration number: CRD42019122176. Keywords: Autism, Asperger, Psychiatric, Diabetes, Epidemiology, Systematic review. Article History Received: August 08, 2020 Revised: November 01, 2020 Accepted: November 23, 2020 1. INTRODUCTION Autism Spectrum Disorders (hereafter referred to as autism) manifest as persistent atypicalities in social comm- * Address correspondence to this author at the Department of Health Sciences, University of Leicester, Leicester, United Kingdom; Tel: 0116 295 5098; Fax: 0116 295 7250; E-mail: sjt56@leicester.ac.uk unication and interaction, and a repertoire of restricted and repetitive patterns of behaviour, present since early development [1]. Recent epidemiological studies estimate rates of approximately 0.95% (95% CI 0.82-1.08) in child [ 2] and 0.76% (95% CI 0.51-1.12) in adult populations [ 3]. People with autism frequently have co-occurring Intellectual Disability (ID) [4] and/or mental health conditions, sometimes requiring