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Acute hyperglycaemia impairs cognitive function in children with IDDM
Insights
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).
- 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.
Objective:
The effects of acute hyperglycaemia on cognitive function in children remain controversial. This study was designed to investigate the suggestion that acute hyperglycaemia impairs cognition in IDDM children.
Design:
To examine this question we studied 12 randomly selected children with IDDM (6 boys, 6 girls, mean age 12.4 years). Cognitive performance was assessed on two occasions at least six months apart (7.4 +/- 1.4 mths, range: 6.3-11.1 mths) under randomised conditions of hyperglycaemia (20-30 mmol/l) on one occasion and euglycaemia (5-10 mmol/l) on the other. Target glucose levels were achieved using a modified clamp technique with subjects and psychologist blinded to the glycaemic level. Cognitive tests chosen to assess performance skills were subtests from the Wechsler Intelligence Scale for Children-3rd Edition (WISC-111).
Results:
No significant learning effect was present. However, there was a reduction in performance IQ at hyperglycaemia compared with euglycaemia (106 +/- 4.3 vs 112 +/- 4.5 IQ points respectively, p < 0.05). Under hyperglycaemic conditions the mean decrease in percentile score for performance IQ was 9.5%. Of the 12 children tested, 8 had a decrease in IQ when hyperglycaemic, which was independent of duration of diabetes and long term metabolic control assessed by HbA1c.
Conclusion:
Acute hyperglycaemia results in impairment of complex cognitive function in children with IDDM. This may have important implications for school performance.
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