title: Type 1 diabetes-associated cognitive decline: a meta-analysis and update of the current literature.
abstract: BACKGROUND
  Type 1 diabetes (T1D) can have a significant impact on brain structure and function, which is referred to as T1D-associated cognitive decline (T1DACD). Diabetes duration, early onset disease, and diabetes-associated complications are all proposed as factors contributing to T1DACD. However, there have been no comparisons in T1DACD between children and adults with T1D. To obtain a better insight into the occurrence and effects of T1DACD in T1D, the aim of the present meta-analysis was to investigate differences between children and adults and to analyse factors contributing T1DACD.
  
  
  METHODS
  Two electronic databases were consulted: PubMed and ISI Web of Knowledge. Literature published up until the end of 2013 was included in the analysis. Effect sizes (Cohen's d), which are standardized differences between experimental and control groups, were calculated.
  
  
  RESULTS
  There was a small to modest decrease in cognitive performance in T1D patients compared with non-diabetic controls. Children with T1D performed worse while testing for executive function, full intelligence quotient (IQ), and motor speed, whereas adults with T1D performed worse while testing the full, verbal and performance IQ, part of the executive function, memory, spatial memory, and motor speed. Episodes of severe hypoglycemia, chronic hyperglycemia, and age of onset can be significant factors influencing cognitive function in T1D.
  
  
  CONCLUSIONS
  The findings in the literature suggest that T1DACD is more severe in adults than children, indicating that age and diabetes duration contribute to this T1DACD.
authors.affiliation: Department of Human Physiology and Sports Medicine, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium; Department EA4488, Physical Activity, Muscle, Health, University Lille Nord de France, Lille, France.
authors.forename: Cajsa
authors.initials: C
authors.lastname: Tonoli
authors.forename: Elsa
authors.initials: E
authors.lastname: Heyman
authors.forename: Bart
authors.initials: B
authors.lastname: Roelands
authors.forename: Nathalie
authors.initials: N
authors.lastname: Pattyn
authors.forename: Luk
authors.initials: L
authors.lastname: Buyse
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Piacentini
authors.forename: Serge
authors.initials: S
authors.lastname: Berthoin
authors.forename: Romain
authors.initials: R
authors.lastname: Meeusen
mesh_terms: D000328:Adult; D000367:Age Factors; D002648:Child; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000523:psychology; D006801:Humans; D008568:Memory; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
keywords: diabetes; diabetes-associated cognitive decline; hyperglycemia; hypoglycemia; 关键词：糖尿病，糖尿病相关的认知能力下降，高血糖，低血糖