Neuropsychological Profiles of Children With Type 1 Diabetes 6 Years After Disease Onset

  1. Elisabeth A. Northam, PHD12,
  2. Peter J. Anderson, BA, GRAD DIP (APP PSYCH)12,
  3. Rani Jacobs, BSC, GRAD DIP12,
  4. Matthew Hughes, BBUS, GRAD DIP 12,
  5. Garry L Warne, MBBS, MD3 and
  6. George A. Werther, MBBS, MD3
  1. 1Department of Psychology, Royal Children’s Hospital, Melbourne
  2. 2Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne
  3. 3Department of Endocrinology/Diabetes, Royal Children’s Hospital, Melbourne, Australia

    Abstract

    OBJECTIVE—To describe neuropsychological profiles and their relationship to metabolic control in children with type 1 diabetes 6 years after the onset of disease.

    RESEARCH DESIGN AND METHODS—Children with type 1 diabetes (n = 90), aged 6–17 years, who had previously been assessed soon after diagnosis and 2 years later, were reevaluated 6 years after the onset of disease. Their neuropsychological profiles were compared with those of individuals in a community control group (n = 84), who had been assessed at similar intervals. Relationships between illness variables, such as age at the onset of disease and metabolic control history, and neuropsychological status were also examined.

    RESULTS—Six years after onset of disease, children with type 1 diabetes performed more poorly than control subjects on measures of intelligence, attention, processing speed, long-term memory, and executive skills. Attention, processing speed, and executive skills were particularly affected in children with onset of disease before 4 years of age, whereas severe hypoglycemia was associated with lower verbal and full-scale intelligence quotient scores.

    CONCLUSIONS—Neuropsychological profiles of children with type 1 diabetes 6 years after the onset of disease are consistent with subtle compromise of anterior and medial temporal brain regions. Severe hypoglycemia, particularly in very young children, is the most plausible explanation for neuropsychological deficits, but the contributory role of chronic hyperglycemia warrants further exploration.

    Footnotes

    • Address correspondence and reprint requests to Elisabeth Northam, Department of Psychology, Royal Children’s Hospital, Parkville, Victoria, 3052, Australia. E-mail: northaml{at}cryptic.rch.unimelb.edu.au.

      Received for publication 27 October 2000 and accepted in revised form 16 May 2001.

      A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

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