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Cognitive functioning, metabolic control, and treatment type in youth with type 1 diabetes
Background:
There is growing evidence that cognitive functioning plays an important role in self-care behavior and glycemic control in pediatric patients with type 1 diabetes. The aim of this pilot study was to examine whether there were differences in glycemic control and cognitive functioning between youth with T1D treated with continuous subcutaneous insulin infusion and multiple daily injections.
Methods:
The sample consisted of 29 youth diagnosed with type 1 diabetes ages 6-15 years (mean age=11.72 years) receiving care at an outpatient pediatric endocrinology clinic. Youth were administered the Wechsler Abbreviated Scale of Intelligence and Wide Range Assessment of Memory and Learning. Independent samples t-tests were used to compare youth with T1D treated with MDI vs. CSII on glycemic control, verbal memory, visual memory, attention/concentration, and intelligence.
Results:
Mean intelligence scores for the insulin pump sample were higher than the daily injection sample. This difference was a medium to large effect. After controlling for demographic variables, age of onset for diabetes, and glycemic control, treatment type was still a significant predictor of intelligence demonstrating that CSII was associated with higher intelligence scores.
Conclusion:
The use of standardized measures of cognitive functioning in routine clinical care may shed some light on the complex interplay between cognitive functioning, treatment type, and glycemic control when managing pediatric patients with T1D.
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