Longitudinal Evaluation of Cognitive Functioning in Young Children with Type 1 Diabetes over 18 Months
Year: 2016
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: Decrements in cognitive function may already be evident in young children with type 1 diabetes (T1D). Here we report prospectively acquired cognitive results over 18 months in a large cohort of young children with and without T1D. METHODS: A total of 144 children with T1D (mean HbA1c: 7.9%) and 70 age-matched healthy controls (mean age both groups 8.5 years; median diabetes duration 3.9 years; mean age of onset 4.1 years) underwent neuropsychological testing at baseline and after 18-months of follow-up. We hypothesized that group differences observed at baseline would be more pronounced after 18 months, particularly in those T1D patients with greatest exposure to glycemic extremes. RESULTS: Cognitive domain scores did not differ between groups at the 18 month testing session and did not change differently between groups over the follow-up period. However, within the T1D group, a history of diabetic ketoacidosis (DKA) was correlated with lower Verbal IQ and greater hyperglycemia exposure (HbA1c area under the curve) was inversely correlated to executive functions test performance. In addition, those with a history of both types of exposure performed most poorly on measures of executive function. CONCLUSIONS: The subtle cognitive differences between T1D children and nondiabetic controls observed at baseline were not observed 18 months later. Within the T1D group, as at baseline, relationships between cognition (Verbal IQ and executive functions) and glycemic variables (chronic hyperglycemia and DKA history) were evident. Continued longitudinal study of this T1D cohort and their carefully matched healthy comparison group is planned.
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Bristol-Myers Squibb, Yale University, Washington University in St. Louis, Nemours Foundation, Novo Nordisk, Vedecká Grantová Agentúra MŠVVaŠ SR a SAV, National Institutes of Health, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Daiichi Sankyo Europe
Awards: G1382993467, G1710560448, Coordinating Center for Studies of Glucose Sensors in T*, Prevention of Nocturnal Hypoglycemia: Effect on Neurologic Outcome in Toddlers, Type 1 diabetes and the brain in children: Metabolic interventions, G36923461, Hypoglycemia in Children and Adolescents with T1DM: Mechanisms and Prevention, Prevention of Hypoglycemia and Associated Complications in Type 1 Diabetes, Washington University Institute of Clinical and Translational Sciences, Washington University Institute of Clinical and Translational Sciences (UL1), Diabetes Research in Children Network (DirecNet), G9000271159, G9000341166, Diabetes Research Center, Yale Diabetes Research Center, G906084563, Yale Study of Closed-Loop Automated Glucose Control for Hypoglycemia Prevention
OpenAlex ID: W2306146784