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Kids with type 1 diabetes have impaired cognition

14 Nov 2018

Type 1 diabetes impairs cognitive functioning in children, and this effect is exacerbated by extreme glycaemic levels, according to a recent meta-analysis.

A search of the databases of Medline, Embase and PsycINFO resulted in 19 included studies, yielding a cumulative sample of 1,355 type 1 diabetes patients and 696 controls. Only those with participants aged <18 years were eligible.

Pooled analysis showed that the diabetic children performed significantly poorer across several domains of cognition. Relative to healthy controls, patients scored lower on overall cognition performance tests (g, –0.46; p<0.01).

The same was true for full-scale intelligence quotient (g, –1.08; p=0.03), attention (g, –0.60; p=0.047) and psychomotor speed (g, –0.46; p=0.02). In contrast, no such difference was observed for the domains of verbal intelligence quotient (g, –0.95; p=0.101), performance intelligence quotient (g, –0.50; p=0.134), verbal memory (g, –0.09; p=0.649), visual memory (g, –0.34; p=0.418), spatial memory (g, –0.81; p=0.195) and executive function (g, 0.02; p=0.943).

In subsequent subgroup analyses, researchers found children with vs without severe hypoglycaemic episodes had significantly lower scores in overall cognition (g, –0.18; p=0.020) and memory (g, –0.25; p=0.032).

Moreover, in children with high glycated haemoglobin levels (>8.0 percent), hypoglycaemic episodes were correlated with poorer overall cognitive function (g, –0.18; p=0.020) and memory (g, –0.27; p=0.041).

Glycaemic extremes had no significant impact on other domains of cognitive function such as psychomotor speed, executive function, attention, and performance and verbal intelligence quotients.

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