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Cognitive Function in Early Onset Type 1 Diabetes in Children.

K Swaminathan1, Pamali Mahasweta Nanda1, Jaivinder Yadav2

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Children with early-onset type 1 diabetes (T1D) exhibit lower cognitive function and IQ. Poor glycemic control and severe hypoglycemia are linked to these deficits, highlighting the need for better management in young T1D patients.

Keywords:
CognitionDKAEarly onset diabetesHypoglycemiaIQType 1 diabetes

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Area of Science:

  • Pediatric Endocrinology
  • Neuroscience
  • Developmental Psychology

Background:

  • Type 1 Diabetes (T1D) is a chronic autoimmune condition requiring lifelong management.
  • Early-onset T1D, diagnosed before age 6, presents unique challenges in growth and development.
  • Cognitive function in children with T1D is an area of growing concern, particularly in diverse populations.

Purpose of the Study:

  • To evaluate cognitive function in Indian children diagnosed with early-onset T1D.
  • To identify factors influencing cognitive performance in this vulnerable group.
  • To compare cognitive outcomes between children with early-onset T1D and healthy controls.

Main Methods:

  • A cross-sectional study involving 60 children with early-onset T1D (onset < 6 years, disease duration ≥ 2 years) and 60 age/sex-matched controls.
  • Cognitive assessment utilized Malin's Intelligence Scale for Indian Children (MISIC).
  • Exclusion criteria included birth asphyxia, intellectual disability, syndromic conditions, and pre-existing psychiatric illness.

Main Results:

  • Children with early-onset T1D demonstrated significantly lower scores across most MISIC subtests, including verbal, performance, and overall Intelligence Quotient (IQ).
  • Poor glycemic control (HbA1c > 9%), history of severe hypoglycemia, and shorter duration since the last diabetic ketoacidosis (DKA) episode were associated with reduced neurocognitive scores.
  • Average IQ in the T1D group was 100.62 ± 3.26 compared to 103.23 ± 1.22 in the control group.

Conclusions:

  • Early-onset T1D is associated with significant deficits in cognitive domains and overall IQ.
  • Suboptimal glycemic control, heightened glycemic variability, and severe hypoglycemia are identified as critical risk factors impacting cognitive development in these children.
  • Longitudinal research is recommended to further elucidate the complex interplay of factors affecting cognitive outcomes in T1D children within developing countries.