Diabetic ketoacidosis and memory dysfunction in children with type 1 diabetes.
OBJECTIVE
We tested the hypothesis that diabetic ketoacidosis (DKA) results in memory deficits typical of hypoxic/ischemic injury because recent studies suggest that cerebral metabolic changes similar to those observed in hypoxic/ischemic cerebral injury are observed in children with DKA, even without symptoms suggesting cerebral injury.


METHODS
Thirty-three children with type 1 diabetes mellitus (T1DM) and a history of DKA and 29 children with T1DM without a history of DKA were enrolled from an academic hospital pediatric endocrinology clinic. These groups were comparable on demographic and disease-related variables. These groups' ability to recall events in association with specific details, the memory function most directly affected by mild hypoxia/ischemia, was compared on 2 tasks (ie, event-color associations and event-spatial position associations).


RESULTS
In multivariate analyses controlling for other critical variables, children with DKA history had significantly lower rates of accurate memory on both tasks (mean, 0.34 +/- 0.13 on the color task and 0.57 +/- 0.15 on the spatial task) than did children without DKA history (mean, 0.44 +/- 0.11 and 0.65 +/- 0.18, P < .01).


CONCLUSIONS
DKA disrupts memory function, underscoring the importance of DKA prevention when T1DM is known and prompt diagnosis of children with new onset of T1DM.
Ghetti
Simona
S
Department of Psychology, University of California, Davis, CA, USA. sghetti@ucdavis.edu
Lee
Joshua K
JK
Sims
Clare E
CE
Demaster
Dana M
DM
Glaser
Nicole S
NS
D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D016883:Diabetic Ketoacidosis / Q000150:complications*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000150:complications; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D015999:Multivariate Analysis; D013647:Task Performance and Analysis