Wright Rohana J, Frier Brian M, Deary Ian J
Department of Diabetes, Royal Infirmary of Edinburgh, Edinburgh, U.K
Diabetes Care. 2009 Aug;32(8):1503-6. doi: 10.2337/dc09-0212. Epub 2009 Jun 1.
OBJECTIVE To examine the effects of acute insulin-induced hypoglycemia on spatial cognitive abilities in adult humans with type 1 diabetes. RESEARCH DESIGN AND METHODS Sixteen adults with type 1 diabetes underwent two counterbalanced experimental sessions: euglycemia (blood glucose 4.5 mmol/l [81 mg/dl]) and hypoglycemia (2.5 mmol/l [45 mg/dl]). Arterialized blood glucose levels were maintained using a hyperinsulinemic glucose clamp technique. During each session, subjects underwent detailed assessment of spatial abilities from the Kit of Factor-Referenced Cognitive Tests and two tests of general cognitive function. RESULTS Spatial ability performance deteriorated significantly during hypoglycemia. Results for the Hidden Patterns, Card Rotations, Paper Folding, and Maze Tracing tests were all impaired significantly (P < or = 0.001) during hypoglycemia, as were results for the Cube Comparisons Test (P = 0.03). The Map Memory Test was not significantly affected by hypoglycemia. CONCLUSIONS Hypoglycemia is a common side effect of insulin therapy in individuals with type 1 diabetes, and spatial abilities are of critical importance in day-to-day functioning. The deterioration in spatial abilities observed during modest experimental hypoglycemia provides novel information on the cerebral hazards of hypoglycemia that has potential relevance to everyday activities.
目的 研究急性胰岛素诱导的低血糖对成年1型糖尿病患者空间认知能力的影响。研究设计与方法 16名成年1型糖尿病患者进行了两个平衡的实验阶段：血糖正常（血糖4.5 mmol/l [81 mg/dl]）和低血糖（2.5 mmol/l [45 mg/dl]）。采用高胰岛素-正葡萄糖钳夹技术维持动脉化血糖水平。在每个阶段，受试者接受了来自因素参照认知测试套件的空间能力详细评估以及两项一般认知功能测试。结果 在低血糖期间，空间能力表现显著下降。在低血糖期间，隐藏图案、卡片旋转、折纸和迷宫追踪测试的结果均显著受损（P≤0.001），立方体比较测试的结果也受损（P = 0.03）。地图记忆测试未受低血糖的显著影响。结论 低血糖是1型糖尿病患者胰岛素治疗的常见副作用，而空间能力在日常功能中至关重要。在适度的实验性低血糖期间观察到的空间能力下降提供了关于低血糖对大脑危害的新信息，这与日常活动可能相关。
