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Effects of Type 1 Diabetes on Neurocognition in Children and Adolescents

Dominant-hand psychomotor impairment in speed was significantly associated with poor glycemic control….

Previous studies have indicated that damage to posterior white matter tracts and associated gray matter regions in type 1 diabetes can impair psychomotor speed. In this study, Dr. Schwartz and colleagues looked at 147 children and adolescents aged 5-18 years old who underwent neuropsychological testing for new-onset type 1 diabetes. The analysis of variance (ANOVA) was used when comparing children before 8 years old and children between 9-18 years old with an onset of type 1 diabetes. The regression analyses were used to relate neurocognitive performance and glycemic control at diagnosis and about 1 year after the diagnosis.

Based on the study, the children performed significantly lower than expected on most of the neurocognitive measures (P<0.0001). Psychomotor speed, visual-motor integration, and phonemic fluency were all affected. About one year after the diagnosis, dominant-hand psychomotor speed was significantly associated with poor glycemic control (HbA1c ≥9.5%; P=.032), with adjustments made for ethnicity, sex, and reading ability. Impaired psychomotor speed was associated with a mean HbA1c increase of 0.77%. These neurocognitive impairments were noticeable within days of diagnosis for diabetes.

The study shows an association between type 1 diabetes and neurocognitive impairment. Impairment was most prevalent in psychomotor speed. Preventive interventions and neuropsychological testing at diagnosis of type 1 should be considered as part of long-term diabetes management according to the researchers.

Practice Pearls:                       
  • Previous research has implicated damage to posterior white matter tracts and associated gray matter regions in type 1 diabetes, which impairs psychomotor speed.
  • Dominant-hand psychomotor speed was significantly associated with poor glycemic control.
  • Impairment was most prevalent in psychomotor speed.

Schwartz DD, Axelrad ME, Anderson BJ. Neurocognitive Functioning in Children and Adolescents at the Time of Type 1 Diabetes Diagnosis: Associations With Glycemic Control 1 Year After Diagnosis. Diabetes Care; DOI: 10.2337/dc14-0103. 2014 July 3.