Sachon C, Grimaldi A, Digy J P, Pillon B, Dubois B, Thervet F
Service Diabetologie, C.H.U. Pitie, Paris, France.
J Intern Med. 1992 May;231(5):471-5. doi: 10.1111/j.1365-2796.1992.tb00962.x.
A series of seven psychometric tests, to evaluate mental concentration and the ability to retain selective attention, lexical fluency, wordlist memorizing and psychomotor speed, was performed on 25 non-diabetic control subjects and 55 insulin-dependent diabetes (IDD) patients of similar social background and professional status. When tested, none of the diabetics was hypoglycaemic and these patients were divided into two groups: Group I: 30 IDD patients unaware of hypoglycaemia, and experiencing frequent and severe episodes of hypoglycaemia. Group II: 25 IDD patients aware of hypoglycaemia. Groups I and II had experienced the disease for the same period of time (17 +/- 13 vs. 14 +/- 11 years, respectively) and they had similar HbA1c levels (7.14 +/- 1.25% vs. 8.6 +/- 1.88%, respectively) and degenerative complications. Compared with the scores of the controls, the Group I scores were lower in four tests: trail-making part A (psychomotor speed; P less than 0.001) and part B (retaining selective attention; P less than 0.01), lexical fluency (P less than 0.01) and Rey auditory-verbal learning test (wordlist learning; P less than 0.05). Group II scores were lower in two tests: trail-making part A (P less than 0.01) and part B (P less than 0.05). In word memorizing, the performance of Group I was inferior to that of Group II (P less than 0.05). In general, these psychometric tests showed that IDD scores were lower than those of the controls, with an average of 67% for Group II and 80% for Group I. Chronic hyperglycaemia and severe hypoglycaemia may have a deleterious effect on cognitive performance. In particular, several severe episodes of hypoglycaemia could be responsible for permanent memory impairment.
对25名非糖尿病对照受试者和55名具有相似社会背景和职业地位的胰岛素依赖型糖尿病（IDD）患者进行了一系列七项心理测量测试，以评估精神集中度、保持选择性注意力的能力、词汇流畅性、单词表记忆和心理运动速度。测试时，所有糖尿病患者均未出现低血糖，这些患者被分为两组：第一组：30名未意识到低血糖且经常发生严重低血糖发作的IDD患者。第二组：25名意识到低血糖的IDD患者。第一组和第二组患糖尿病的时间相同（分别为17±13年和14±11年），他们的糖化血红蛋白水平相似（分别为7.14±1.25%和8.6±1.88%），且有相似的退行性并发症。与对照组的分数相比，第一组在四项测试中的分数较低：连线测验A部分（心理运动速度；P<0.001）和B部分（保持选择性注意力；P<0.01）、词汇流畅性（P<0.01）和雷氏听觉词语学习测验（单词表学习；P<0.05）。第二组在两项测试中的分数较低：连线测验A部分（P<0.01）和B部分（P<0.05）。在单词记忆方面，第一组的表现不如第二组（P<0.05）。总体而言，这些心理测量测试表明，IDD患者的分数低于对照组，第二组平均为67%，第一组为80%。慢性高血糖和严重低血糖可能对认知表现产生有害影响。特别是，几次严重的低血糖发作可能导致永久性记忆损害。
