Neurocognitive Outcomes in Young Adults With Early Onset Type 1 Diabetes

A prospective follow-up study

  1. Timothy W. Jones, FRACP, MD1,2,4
  1. 1Department of Endocrinology & Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
  2. 2School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
  3. 3Neurocognitive Development Unit, School of Psychology, University of Western Australia, Perth, Western Australia, Australia
  4. 4Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
  1. Corresponding author: Trang T. Ly, Trang.Ly{at}health.wa.gov.au.

Abstract

OBJECTIVE The aim of this study was to reexamine the neurocognitive function of a cohort of young adults with early onset type 1 diabetes and compare their cognitive function to a matched control group. We also examined whether cognitive function was related to prospectively obtained severe hypoglycemia history, long-term glycemic control, or severe diabetic ketoacidosis.

RESEARCH DESIGN AND METHODS Testing included Wechsler Intelligence Scale for Children and Adults, Wechsler Memory Scale, Cattell Culture Fair Intelligence Test (CCFIT), Wisconsin Card Sorting Test (WCST), youth and adult self-report, and Beck Depression Inventory. We tested 34 control subjects (mean ± SE, age 19.5 ± 0.5 years) and 33 type 1 diabetes subjects (age 19.3 ± 0.5 years, age at type 1 diabetes onset 3.3 ± 0.3 years, A1C from diagnosis 8.7 ± 0.1%, and diabetes duration 16.0 ± 0.5 years).

RESULTS There was no difference in full-scale IQ scores in type 1 diabetes and control subjects (100.7 ± 2.0 vs. 102.5 ± 1.4). There was no difference between groups in memory subtests or in reporting of emotional and behavioral difficulties. The type 1 diabetes group scored lower on the CCFIT for fluid intelligence compared with control subjects (P = 0.028) and also scored lower on WCST with more perseverative errors (P = 0.002) and fewer categories completed (P = 0.022).

CONCLUSIONS These data suggest no difference in general intellectual ability, memory, and emotional difficulties in our cohort of young adults with early onset type 1 diabetes compared with control subjects and no deterioration over time. There were, however, findings to suggest subtle changes leading to poorer performance on complex tasks of executive function.

  • Received April 13, 2011.
  • Accepted July 11, 2011.

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This Article

  1. Diabetes Care
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