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Effect of metabolic control on cognitive functions in children and adolescents with type 1 diabetes mellitus

Şeyma Kar1, Eren Er2, Aysun Ata2

  • 1Department of Child Health and Diseases, Ege University Faculty of Medicine, İzmir, Türkiye.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|May 5, 2023
PubMed

Insights

Children with type 1 diabetes (T1D) show poorer neurocognitive function, particularly with poor metabolic control and a history of diabetic ketoacidosis (DKA). Early assessment and precautions are recommended for better outcomes.

Area of Science:

  • Pediatric Endocrinology
  • Neuroscience
  • Child Psychology

Background:

  • Type 1 diabetes (T1D) is associated with potential neurocognitive deficits in children.
  • Factors like metabolic control and diabetic ketoacidosis (DKA) may influence cognitive outcomes.
  • Understanding these impacts is crucial for comprehensive T1D management.

Purpose of the Study:

  • To evaluate the impact of age of onset, metabolic control, and insulin regimen on neurocognitive functions in children and adolescents with T1D.
  • To compare neurocognitive performance between children with T1D and healthy peers.
  • To identify specific diabetes-related factors affecting cognitive abilities.

Main Methods:

  • Forty-seven children (6-18 years) with T1D (duration ≥ 5 years) were assessed.
  • Neurocognitive functions including intelligence (WISC-R), memory (GISD-B), visual-motor perception (Bender Gestalt), and attention/impulsivity (Moxo-dCPT) were evaluated.
  • Exclusion criteria included psychiatric disorders or other chronic diseases.

Main Results:

  • Children with T1D exhibited lower verbal, performance, and total IQ scores compared to healthy controls (p<0.05).
  • The T1D group showed higher impulsivity on the Moxo-dCPT (p=0.04).
  • Poorer metabolic control and a history of DKA were linked to diminished verbal, performance, and total IQ scores.

Conclusions:

  • Poor metabolic control and a history of DKA negatively affect neurocognitive functions in children with T1D.
  • Neurocognitive function assessment should be considered in the routine care of children with T1D.
  • Proactive management strategies are necessary to mitigate adverse cognitive effects.
Abstract

Keywords:
cognitive functionhyperglycemiahypoglycemiatype 1 diabetes

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