Neuropsychological profiles of young people with type 1 diabetes 12 yr after disease onset.
BACKGROUND
Lowered neuropsychological performance is evident in youth with type 1 diabetes, although evidence for associations with specific illness variables is inconsistent. This study examined the neuropsychological profiles of a cohort of youth with type 1 diabetes studied prospectively from diagnosis 12 yr previously.


METHODS
A total of 106 youth with type 1 diabetes and 75 healthy controls participated. There were no significant group differences on Full-scale IQ assessed on study entry 12 yr previously, current socioeconomic status, gender distribution, or age. Neuropsychological tests assessed eight cognitive domains: verbal abilities, perceptual reasoning, new learning, working memory, non-verbal processing speed, mental efficiency, divided attention, and sustained attention. Episodes of serious hypoglycemia and HbA(1c) levels were recorded from diagnosis.


RESULTS
Youth with type 1 diabetes performed more poorly than controls on working memory (p < .05). Early onset diabetes was related to poorer sustained (p < .001) and divided attention (p = .001), new learning, and mental efficiency (both p < .05). Hypoglycemia was found to adversely effect verbal abilities, working memory, and non-verbal processing speed (all p < .05). Poorer working memory was associated with hyperglycemia (p < .05). Youth with any combination of two or three illness risk factors (i.e., early onset diabetes, hypo-, hyperglycemia), performed more poorly than controls and youth with no or one risk on verbal abilities, working memory, and mental efficiency.


CONCLUSIONS
This study documents poorer neuropsychological performance and its association with illness risk factors in youth with type 1 diabetes. Findings suggest that early disease onset and hypoglycemia impact on the developing central nervous system, with hyperglycemia playing a lesser role.
Lin
Ashleigh
A
Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia. ashlin@unimelb.edu.au
Northam
Elisabeth A
EA
Rankins
Debbie
D
Werther
George A
GA
Cameron
Fergus J
FJ
D000293:Adolescent; D001288:Attention; D003071:Cognition; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000523:psychology; D007003:Hypoglycemia / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008570:Memory, Short-Term; D009483:Neuropsychological Tests; D011340:Problem Solving; D011446:Prospective Studies; D014706:Verbal Learning; D055815:Young Adult
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human