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.

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.
Abstract

Related Concept Videos

Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...