Cognitive Function in Early Onset Type 1 Diabetes in Children.

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.