Northam E A, Anderson P J, Jacobs R, Hughes M, Warne G L, Werther G A
Department of Psychology, Royal Children's Hospital, Melbourne, Parkville, Victoria 3052, Australia.
Diabetes Care. 2001 Sep;24(9):1541-6. doi: 10.2337/diacare.24.9.1541.
To describe neuropsychological profiles and their relationship to metabolic control in children with type 1 diabetes 6 years after the onset of disease.
Children with type 1 diabetes (n = 90), aged 6-17 years, who had previously been assessed soon after diagnosis and 2 years later, were reevaluated 6 years after the onset of disease. Their neuropsychological profiles were compared with those of individuals in a community control group (n = 84), who had been assessed at similar intervals. Relationships between illness variables, such as age at the onset of disease and metabolic control history, and neuropsychological status were also examined.
Six years after onset of disease, children with type 1 diabetes performed more poorly than control subjects on measures of intelligence, attention, processing speed, long-term memory, and executive skills. Attention, processing speed, and executive skills were particularly affected in children with onset of disease before 4 years of age, whereas severe hypoglycemia was associated with lower verbal and full-scale intelligence quotient scores.
Neuropsychological profiles of children with type 1 diabetes 6 years after the onset of disease are consistent with subtle compromise of anterior and medial temporal brain regions. Severe hypoglycemia, particularly in very young children, is the most plausible explanation for neuropsychological deficits, but the contributory role of chronic hyperglycemia warrants further exploration.
描述1型糖尿病患儿发病6年后的神经心理学特征及其与代谢控制的关系。
选取90例6 - 17岁的1型糖尿病患儿，这些患儿在诊断后不久及2年后曾接受评估，此次在发病6年后进行重新评估。将他们的神经心理学特征与社区对照组（84例）在相似时间间隔评估的个体进行比较。还研究了疾病变量（如发病年龄和代谢控制史）与神经心理状态之间的关系。
发病6年后，1型糖尿病患儿在智力、注意力、处理速度、长期记忆和执行技能等方面的表现比对照组差。4岁前发病的患儿注意力、处理速度和执行技能受影响尤为明显，而严重低血糖与较低的言语和全量表智商得分相关。
1型糖尿病患儿发病6年后的神经心理学特征与颞叶前部和内侧脑区的细微损害一致。严重低血糖，尤其是在幼儿中，是神经心理缺陷最合理的解释，但慢性高血糖的作用也值得进一步探索。
