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Item
#9
Impaired Intellectual Development in
Children with Type 1 Diabetes
Associated
with HbA1 c, age at diagnosis and sex.
Aims/hypothesis: Good
metabolic control in diabetic children is already crucial before
puberty to prevent diabetic complications later in life. However,
tight metabolic control could increase the risk of severe
hypoglycemia, which might be responsible for impaired intellectual
performance later in life. The purpose of this prospective
longitudinal study was to evaluate the relevance of long-term
metabolic control and hypoglycemia possibly affecting the
intellectual development of young children with Type I
(insulin-dependent) diabetes mellitus.
Methods:
The intellectual development in 64 diabetic children between the
ages of 7 and 16 years was assessed at least four times using the
German version of the Hamburg Wechsler intelligence scale for
preschool children, Children-Revised and by the "Adaptives
Intelligenz Diagnostikum" (Adaptive Intelligence
Diagnosticum). Data were analyzed longitudinally compared with a
control group.
Results:
A significant decline in performance by age 7 and in verbal
intelligence quotient between age 7 and 16 years was observed in
diabetic boys diagnosed before the age of 6 but not in those
diagnosed later and not in diabetic girls. The deterioration of
intellectual performance in boys diagnosed at a very young age was
not associated with the occurrence of severe hypoglycemic episodes
but was correlated with the degree of metabolic deterioration at
diagnosis and with high long-term average of glycated hemoglobin.
Conclusion/interpretation:
Our study in diabetic children shows that the male sex, diagnosis
at a young age, metabolic condition at diagnosis and long-term
metabolic control, rather than experienced hypoglycemic attacks
are risk factors for intellectual development. Diabetologia
(2002) 45: 108-114
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FACT:
More
than two thirds (68 percent) of people with diabetes surveyed do
not consider cardiovascular disease, such as heart attacks and
stroke, to be a serious complication of diabetes.
Fact: At least two thirds of all deaths in people with diabetes are caused
by cardiovascular disease. Heart attacks occur at an earlier age
in people with diabetes and often result in premature death.
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