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Published on: October 23, 2020
Cognitive functioning in young children with type 1 diabetes
M Allison Cato1, Nelly Mauras2, Jodie Ambrosino3
11 Divsions of Neurology, Nemours Children's Clinic, Jacksonville, Florida.
Insights
Children with type 1 diabetes (T1D) show subtle cognitive differences, particularly in executive functions, compared to healthy peers. Glycemic history may influence these cognitive outcomes in young children.
Area of Science:
- Pediatric Endocrinology
- Neuropsychology
- Child Development
Background:
- Type 1 diabetes (T1D) is a chronic condition affecting children.
- Cognitive function is crucial for development and academic success.
- Understanding T1D's impact on cognition is vital for early intervention.
Purpose of the Study:
- To assess cognitive functioning in young children with T1D.
- To investigate the influence of glycemic history on cognitive performance.
- To compare cognitive domains between children with T1D and healthy controls.
Main Methods:
- Neuropsychological evaluation of 216 children (ages 4-10).
- Included healthy controls (n=72) and T1D cohort (n=144).
- Assessed IQ, Executive Functions, Learning/Memory, Processing Speed, and behavioral symptoms; collected glycemic history.
Main Results:
- Children with T1D trended lower in IQ and Executive Functions (p=0.02).
- No significant differences in Learning/Memory or Processing Speed.
- Parents reported more depressive/somatic symptoms in children with T1D (p<0.001).
- Hyperglycemia trends associated with Executive Functions, IQ, and Learning/Memory.
Conclusions:
- Subtle cognitive differences may exist in young children with T1D early in the disease course.
- Glycemic history shows a potential association with cognitive function.
- Longitudinal studies are needed to track cognitive changes over time.
Abstract:
The aim of this study was to assess cognitive functioning in children with type 1 diabetes (T1D) and examine whether glycemic history influences cognitive function. Neuropsychological evaluation of 216 children (healthy controls, n = 72; T1D, n = 144) ages 4-10 years across five DirecNet sites. Cognitive domains included IQ, Executive Functions, Learning and Memory, and Processing Speed. Behavioral, mood, parental IQ data, and T1D glycemic history since diagnosis were collected. The cohorts did not differ in age, gender or parent IQ. Median T1D duration was 2.5 years and average onset age was 4 years. After covarying age, gender, and parental IQ, the IQ and the Executive Functions domain scores trended lower (both p = .02, not statistically significant adjusting for multiple comparisons) with T1D relative to controls. Children with T1D were rated by parents as having more depressive and somatic symptoms (p < .001). Learning and memory (p = .46) and processing speed (p = .25) were similar. Trends in the data supported that the degree of hyperglycemia was associated with Executive Functions, and to a lesser extent, Child IQ and Learning and Memory. Differences in cognition are subtle in young children with T1D within 2 years of onset. Longitudinal evaluations will help determine whether these findings change or become more pronounced with time.
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