title: Effects of Diabetic Ketoacidosis on Visual and Verbal Neurocognitive Function in Young Patients Presenting with New-Onset Type 1 Diabetes.
abstract: OBJECTIVE
  To evaluate the effects of diabetic ketoacidosis (DKA) on neurocognitive functions in children and adolescents presenting with new-onset type 1 diabetes.
  
  
  METHODS
  Newly diagnosed patients were divided into two groups: those with DKA and those without DKA (non-DKA). Following metabolic stabilization, the patients took a mini-mental status exam prior to undergoing a baseline battery of cognitive tests that evaluated visual and verbal cognitive tasks. Follow-up testing was performed 8-12 weeks after diagnosis. Patients completed an IQ test at follow-up.
  
  
  RESULTS
  There was no statistical difference between the DKA and non-DKA groups neither in alertness at baseline testing nor in an IQ test at follow-up. The DKA group had significantly lower baseline scores than the non-DKA group for the visual cognitive tasks of design recognition, design memory and the composite visual memory index (VMI). At follow-up, Design Recognition remained statistically lower in the DKA group, but the design memory and the VMI tasks returned to statistical parity between the two groups. No significant differences were found in verbal cognitive tasks at baseline or follow-up between the two groups. Direct correlations were present for the admission CO2 and the visual cognitive tasks of VMI, design memory and design recognition. Direct correlations were also present for admission pH and VMI, design memory and picture memory.
  
  
  CONCLUSIONS
  Pediatric patients presenting with newly diagnosed type 1 diabetes and severe but uncomplicated DKA showed a definite trend for lower cognitive functioning when compared to the age-matched patients without DKA.
authors.forename: Ashley B
authors.initials: AB
authors.lastname: Jessup
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Grimley
authors.forename: Echo
authors.initials: E
authors.lastname: Meyer
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Passmore
authors.forename: Ayşenil
authors.initials: A
authors.lastname: Belger
authors.forename: William H
authors.initials: WH
authors.lastname: Hoffman
authors.affiliation: University of North Carolina at Chapel Hill Faculty of Medicine, Division of Pediatric Endocrinology, North Carolina, United States of America Phone: +1 919 962 27 96 E-mail: asc@med.unc.edu.
authors.forename: Ali S
authors.initials: AS
authors.lastname: Çalıkoğlu
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D016009:Chi-Square Distribution; D002648:Child; D003071:Cognition / Q000502:physiology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D014706:Verbal Learning / Q000502:physiology*
chemical_list: D001786:Blood Glucose
references.citation: Stroke. 1990 Mar;21(3):451-8
references.pmid: 2408198
references.citation: Pediatr Diabetes. 2006 Feb;7(1):11-5
references.pmid: 16489969
references.citation: Endocr Res. 2002 Feb-May;28(1-2):91-102
references.pmid: 12108794
references.citation: Diabetes. 1982 Oct;31(10):923-8
references.pmid: 6818069
references.citation: Diabetes. 2015 May;64(5):1770-9
references.pmid: 25488901
references.citation: Clin Immunol. 2005 Jul;116(1):11-7
references.pmid: 15925827
references.citation: Diabet Med. 2001 Sep;18(9):761-3
references.pmid: 11606176
references.citation: Brain Res. 2010 Jul 9;1343:168-77
references.pmid: 20420811
references.citation: Am J Physiol. 1990 Nov;259(5 Pt 1):E723-8
references.pmid: 2122740
references.citation: Microcirculation. 2013 Aug;20(6):534-43
references.pmid: 23441883
references.citation: Brain Res. 2011 Jan 19;1369:194-202
references.pmid: 21040714
references.citation: Rev Diabet Stud. 2009 Spring;6(1):37-42
references.pmid: 19557294
references.citation: Diabetes. 2012 Jul;61(7):1814-21
references.pmid: 22438575
references.citation: J Diabetes Complications. 1999 Mar-Apr;13(2):91-7
references.pmid: 10432173
references.citation: J Diabetes Complications. 2002 Jul-Aug;16(4):294-300
references.pmid: 12126788
references.citation: Biol Psychiatry. 2009 Nov 1;66(9):879-85
references.pmid: 19709646
references.citation: Clin Biochem. 2003 Jun;36(4):269-73
references.pmid: 12810155
references.citation: Pediatrics. 2008 May;121(5):e1258-66
references.pmid: 18450868
references.citation: J Pediatr Psychol. 2009 Apr;34(3):271-82
references.pmid: 18635605
references.citation: Brain Res. 2004 May 1;1006(2):157-67
references.pmid: 15051519
references.citation: Clin Immunol. 2003 Sep;108(3):175-81
references.pmid: 14499240
references.citation: AJNR Am J Neuroradiol. 2010 Apr;31(4):780-1
references.pmid: 19926705
references.citation: Eur J Neurosci. 2006 Mar;23(6):1539-46
references.pmid: 16553617
references.citation: Diabetes Metab. 2006 Apr;32(2):176-80
references.pmid: 16735968
references.citation: J Child Neurol. 2010 Apr;25(4):469-74
references.pmid: 19762507
references.citation: Brain Res. 2009 Feb 13;1254:138-48
references.pmid: 19103180
references.citation: Eur Radiol. 2004 Mar;14(3):549-51
references.pmid: 15035255
references.citation: Diabetologia. 2002 Jan;45(1):108-14
references.pmid: 11845229
references.citation: Ann Clin Lab Sci. 2003 Fall;33(4):435-42
references.pmid: 14584758
references.citation: Brain Res. 2008 Oct 31;1238:154-62
references.pmid: 18775683
references.citation: Pediatr Diabetes. 2006 Oct;7(5):289-97
references.pmid: 17054452
references.citation: Diabetes Care. 1982 May-Jun;5 Suppl 1:38-47
references.pmid: 6821306
references.citation: Diabetes Care. 2005 Jun;28(6):1431-7
references.pmid: 15920064
references.citation: J Pediatr. 2010 Jan;156(1):109-14
references.pmid: 19833353
references.citation: Nat Neurosci. 2008 Mar;11(3):309-17
references.pmid: 18278039
references.citation: Diabetes Care. 2008 Sep;31(9):1892-7
references.pmid: 18753668
references.citation: Neurobiol Aging. 2012 Jan;33(1):196.e1-12
references.pmid: 20594617
references.citation: J Psychosom Res. 2002 Oct;53(4):907-11
references.pmid: 12377302
references.citation: Diabetes Care. 2012 Dec;35(12):2443-6
references.pmid: 23033243
references.citation: Biol Psychiatry. 2012 Jan 1;71(1):15-21
references.pmid: 22047718
references.citation: Diabetes Care. 2008 Oct;31(10):1933-8
references.pmid: 18606979