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Cognitive Performance Issues Due To Type 1 Diabetes

Jan 25, 2020
 
Editor: David L. Joffe, BSPharm, CDE, FACA

Author: Sandra Zaki, PharmD Candidate, Florida A&M University

Different people have different IQs and different cognitive abilities. But could cognitive performance issues sometimes be associated with type 1 diabetes?

Type 1 diabetes changes the activation process of the brain of young patients and affects their performance on visuospatial working memory tasks, according to a recent study. Previous research has mainly focused on young children because it starts in most cases during childhood. Since it affects developing children, it is believed that cognitive functions can be changed at the neurodevelopment stage. According to Brands et al. (2005), people with type 1 diabetes display a reduction in mental speed as well as weakened flexibility of the brain due to cognitive dysfunction. The degree of cognitive weakness is mild to moderate, yet mild forms of cognitive dysfunction can affect daily tasks because they can lead to problems in highly demanding conditions.

The participants of the study were sampled using the inclusion method. Among them, 16 patients/participants had been diagnosed with type 1 diabetes, while 16 formed control subjects who were healthy. The participants were right-handed with average IQs. According to the study, the patients went through disease evolution for four years, and the childhood period was the onset of the disease. The study did not include individuals with neurodevelopmental complications, nephropathy or other type 1 diabetes-related complications. The participants were also arranged by sex, level of education and age. There were anticipated results as the researchers noticed that there were known differences in the level of glucose. In the groups, fasting plasma glucose, as well as glycated hemoglobin, went above the control levels just as usually seen in this particular disease.

Among the participants, fourteen of them used self-administered injections of long-acting or rapid insulin. The two remaining participants got treated through insulin pump therapy, but all of them were required to monitor themselves regularly as far as blood glucose levels were concerned. The analysis of the data was done using SPSS 2011. The analysis of variance was done to determine the major exchange impacts of performance situations as well as the status of the disease on the cognitive functioning of the patient. Patients and controls were used in the analysis as a between-set factor. The right response percentage and standard response times formed the dependent variables. To examine the effect of T1D on cognitive performance, brain activations were done by carrying out an initial-level general linear design analysis for a given participant through the statistical threshold of ά=0.05.

The results were divided according to the analysis conducted. With behavioral status, correct answers, as well as response times during the experiment, were only considered. This is because wrong responses, including the negation of percentages, became too tiny for them to influence the outcome. Broadly, the participants together with the controls displayed uniform behavioral attributes. The results showed that both subjects did not vary in terms of accuracy, as shown by (F(1, 30) = 0.075; p = 0.786. However, since the within-subjects variations between situations were evaluated, the correct response number deviated significantly (F(1, 30) =4.35: p+0.046). The results imaging showed similarity in activation between patients as well as controls. The similarities were observed in the premotor cortex, bilateral parietal lobe, cerebellum and superior frontal gyrus. Despite the similarities, the results also indicated that the two groups differed in cluster size as well as the intensity of activation.

The study shows that people with type 1 diabetes display a varying brain activation model, unlike healthy individuals. Therefore, the study helps in understanding the impacts of type 1 diabetes, especially on children. The understanding could be of use to other researchers specializing in medicine because they will use the findings to come up with alternative medicines for the problem. Future researchers can also learn a lot from this study. The limitation of the study lies in the researchers’ assumption that the glucose amount of the control set would be standard because of the absence of clinical indications of diabetes. There was no proper determination of glucose levels.

Practice Pearls:

  • The study showed that type 1 diabetes has a significant mental effect on patients, especially among those who are young children whose brains are still developing.
  • Type 1 diabetes is complicated, and it can cause significant health problems to the patient with diabetes.
  • Although the study indicated a relationship between cognitive performance problems and type 1 diabetes, it has weaknesses which should be handled in future research.

References for “Cognitive Performance Issues Due To Type 1 Diabetes”:
Brands, Augustina MA, et al. “The effects of type 1 diabetes on cognitive performance: a meta-analysis.” Diabetes care 28.3 (2005): 726-735.

Gallardo-Moreno, Geisa B., et al. “Type 1 diabetes modifies brain activation in young patients while performing visuospatial working memory tasks.” Journal of diabetes research 2015 (2015).

 

Sandra Zaki, PharmD Candidate, Florida A&M University

 

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