Neuropsychological profiles of young people with type 1 diabetes 12 yr after disease onset

Pediatr Diabetes. 2010 Jun;11(4):235-43. doi: 10.1111/j.1399-5448.2009.00588.x. Epub 2010 Jan 7.

Abstract

Background: Lowered neuropsychological performance is evident in youth with type 1 diabetes, although evidence for associations with specific illness variables is inconsistent. This study examined the neuropsychological profiles of a cohort of youth with type 1 diabetes studied prospectively from diagnosis 12 yr previously.

Methods: A total of 106 youth with type 1 diabetes and 75 healthy controls participated. There were no significant group differences on Full-scale IQ assessed on study entry 12 yr previously, current socioeconomic status, gender distribution, or age. Neuropsychological tests assessed eight cognitive domains: verbal abilities, perceptual reasoning, new learning, working memory, non-verbal processing speed, mental efficiency, divided attention, and sustained attention. Episodes of serious hypoglycemia and HbA(1c) levels were recorded from diagnosis.

Results: Youth with type 1 diabetes performed more poorly than controls on working memory (p < .05). Early onset diabetes was related to poorer sustained (p < .001) and divided attention (p = .001), new learning, and mental efficiency (both p < .05). Hypoglycemia was found to adversely effect verbal abilities, working memory, and non-verbal processing speed (all p < .05). Poorer working memory was associated with hyperglycemia (p < .05). Youth with any combination of two or three illness risk factors (i.e., early onset diabetes, hypo-, hyperglycemia), performed more poorly than controls and youth with no or one risk on verbal abilities, working memory, and mental efficiency.

Conclusions: This study documents poorer neuropsychological performance and its association with illness risk factors in youth with type 1 diabetes. Findings suggest that early disease onset and hypoglycemia impact on the developing central nervous system, with hyperglycemia playing a lesser role.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attention*
  • Cognition*
  • Cohort Studies
  • Diabetes Mellitus, Type 1 / psychology*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Hyperglycemia / psychology
  • Hypoglycemia / psychology
  • Longitudinal Studies
  • Male
  • Memory, Short-Term*
  • Neuropsychological Tests
  • Problem Solving*
  • Prospective Studies
  • Verbal Learning*
  • Young Adult

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human