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Acute hyperglycaemia impairs cognitive function in children with IDDM

E A Davis1, S A Soong, G C Byrne

  • 1Department of Diabetes/Endocrinology, Princess Margaret Hospital for Children, Perth, Western Australia.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|July 1, 1996
PubMed
Summary
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Acute high blood sugar levels impair cognitive function in children with insulin-dependent diabetes mellitus (IDDM). This finding suggests potential impacts on academic performance in affected children.

Area of Science:

  • Pediatric Endocrinology
  • Neuropsychology
  • Child Psychology

Background:

  • Cognitive function in children with insulin-dependent diabetes mellitus (IDDM) is influenced by glycemic control.
  • The specific impact of acute hyperglycemia on cognitive performance in this population remains a subject of debate.

Purpose of the Study:

  • To investigate whether acute hyperglycemia impairs cognitive function in children with IDDM.
  • To examine the relationship between elevated blood glucose levels and cognitive performance in pediatric diabetes patients.

Main Methods:

  • A randomized controlled study involving 12 children with IDDM (mean age 12.4 years).
  • Cognitive performance was assessed using Wechsler Intelligence Scale for Children-3rd Edition (WISC-III) subtests under two conditions: acute hyperglycemia (20-30 mmol/l) and euglycemia (5-10 mmol/l).

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  • A modified clamp technique was employed to achieve target glucose levels, with blinding for subjects and the assessing psychologist.

    • Main Results:

    • No significant learning effect was observed between assessments.
    • A statistically significant reduction in performance IQ was noted during hyperglycemia compared to euglycemia (106 +/- 4.3 vs 112 +/- 4.5 IQ points, p < 0.05).
    • Hyperglycemia led to a mean decrease of 9.5% in performance IQ percentile scores, with 8 out of 12 children showing reduced IQ under hyperglycemic conditions, irrespective of diabetes duration or HbA1c levels.

    Conclusions:

    • Acute hyperglycemia demonstrably impairs complex cognitive function in children with IDDM.
    • These findings suggest that elevated blood glucose levels may negatively affect school performance and learning in children with diabetes.