Cognitive Functions and HbA1c Variability in Children and Adolescents with Type 1 Diabetes Mellitus

Project no. 20979 · Status: Kapanmış · 2020

Summary

Introduction and Aim: To investigate the effects of many factors such as diabetes onset age, glycemic control, duration of diabetes, multiple-dose insulin therapy and insulin infusion pump use, and number of DKA attacks on cognitive functions in children aged 6-18 years who are followed up with the diagnosis of Type 1 Diabetes Mellitus. Materials and Methods: Forty-eight children aged 6-18 years, who were followed up with the diagnosis of T1DM for at least 5 years in the Ege University Department of Pediatric Endocrinology and Diabetes, were included in the study. Children with a previously identified psychiatric disorder or other known chronic disease other than T1DM were excluded from the study. 37 healthy children without a known chronic disease formed the control group. In our study, the neurocognitive functions of children with T1DM and healthy children in the control group were examined. In the evaluation of neurocognitive functions, intelligence with Wechsler Children's Intelligence Scale (WISC-R), short-term memory with Audio-Visual Digits Form B (GISD-B) test, visual motor perception with Bender Gestalt Test and BAP (Scientific Research Projects) supported purchased Attention, timing, hyperactivity and impulsivity were evaluated with the Moxo Continuous Attention and Performance test.  Results: A statistically significant difference was found between the groups in terms of the verbal intelligence quotient, performance intelligence quotient and total intelligence quotient mean scores of the Wechsler Intelligence Scale administered between the children with Type 1 Diabetes Mellitus and the control group. (p=0.013 p=0.049 p=0.012). When Moxo Attention and Performance tests were compared, a statistically significant difference was found in Moxo test in terms of Impulsivity. (p=0.04) No difference was found with the control group in all other neurocognitive tests. (p>0.05) When the Type 1 DM group was examined within itself, a statistically significant difference was found between them in terms of verbal intelligence in the WISC-R score distribution between the moderate and poor metabolic control groups according to the degree of metabolic control. (p=0.009) Diabetic ketoacidosis. When the WISC-R score distributions of the two subgroups separated according to their exacerbation status were compared, a significant difference was found in terms of verbal and total intelligence scores. (p=0.023 p=0.041) No statistically significant difference was found in terms of age at diagnosis of diabetes, duration of diabetes, methods used in the treatment of Type 1 Diabetes Mellitus, HbA1c variability and mean. Conclusion: It was observed that poor metabolic control and DKA attack in children with type 1 diabetes adversely affected neurocognitive functions. It is thought that it would be beneficial to consider cognitive factors that negatively affect neurocognitive functions in Type 1 Diabetes Mellitus and to take necessary precautions in the follow-up.

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