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Association between diabetes, severe hypoglycaemia, and electroencephalographic abnormalities
Insights
Electroencephalogram (EEG) abnormalities are more common in diabetic children, particularly those with a history of severe hypoglycemia, young age, and early diabetes onset. Metabolic control did not significantly impact EEG findings.
Area of Science:
- Pediatric Endocrinology
- Neurophysiology
- Metabolic Disorders
Background:
- Type 1 diabetes mellitus (T1DM) affects children globally.
- Neurological complications can arise in pediatric diabetes.
- Electroencephalography (EEG) is a tool to assess brain electrical activity.
Purpose of the Study:
- To investigate the prevalence and risk factors of EEG abnormalities in children with T1DM.
- To correlate EEG findings with clinical parameters of diabetes management.
Main Methods:
- Serial EEG recordings were performed on 70 children with T1DM and 5 control subjects.
- Data collected included age, age at diagnosis, diabetes duration, insulin dose, HbA1 concentration, and history of severe hypoglycemia.
- Statistical analysis related EEG findings to these clinical variables.
Main Results:
- EEG abnormalities were observed in 26% of diabetic children versus 7% of controls.
- No association was found between EEG abnormalities and diabetes duration, insulin dose, or HbA1 levels.
- Younger age at EEG, earlier age at diagnosis, and a history of severe hypoglycemia (especially hypoglycemic convulsions) were significant risk factors for EEG abnormalities.
Conclusions:
- Previous severe hypoglycemia, young age, and early onset of diabetes are key risk factors for EEG abnormalities in children with T1DM.
- Metabolic control, assessed by HbA1, did not influence EEG findings in the early years of the disease.
- EEG monitoring may be considered in diabetic children with specific risk factors.
Abstract:
Serial electroencephalographic recordings were made in 70 diabetic children and findings were related to age at electroencephalography and at diagnosis, duration of diabetes, daily insulin dose, long term metabolic control assessed by glycated haemoglobin A1 (HbA1) concentrations, and severe hypoglycaemic episodes. Abnormalities were found in 18 (26%) of diabetic children, and in only five (7%) of control subjects. There were no associations between electroencephalographic abnormalities and duration of diabetes, daily insulin dose, or HbA1 concentration. Diabetic children with electroencephalographic abnormalities were younger, had an earlier onset of diabetes and 21/34 (62%) of them had previously severe attacks of hypoglycaemia, whereas abnormalities were found in only 13/43 (30%) of diabetic children who had not had severe hypoglycaemia. All diabetic children with hypoglycaemic convulsions had permanent electroencephalographic abnormalities. The degree of metabolic control had no effect on the electroencephalographic findings during the early years of diabetes, but previous severe hypoglycaemia, young age, and early onset seem to be important risk factors for electroencephalographic abnormalities.