Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China.
Medical Psychological Institute of Central South University, Changsha, China.
J Diabetes Investig. 2018 Nov;9(6):1342-1353. doi: 10.1111/jdi.12840. Epub 2018 Apr 17.
AIMS/INTRODUCTION: To examine the magnitude and pattern of cognitive dysfunction in children with type 1 diabetes, and the possible effects associated with other disease variables, such as early onset diabetes, severe hypoglycemia and hyperglycemia.
We carried out a meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We searched MedLine, Embase and PsycINFO to identify studies on cognitive function in children with type 1 diabetes that were published up until 30 September 2016. Effect sizes understood as the standardized mean differences between groups with diabetes and control groups (i.e., Hedges' g) were calculated to quantify the extent of cognitive dysfunction in those groups consisting of children with diabetes.
A total of 19 studies met our inclusion criteria, comprising 1,355 participants with type 1 diabetes and 696 controls. Compared with non-diabetic controls, children with type 1 diabetes showed a significantly poorer cognitive performance overall (g = -0.46), as well as specific deficits in full-scale intelligence (g = -1.06), attention (g = -0.60) and psychomotor speed (g = -0.46). Glycemic extremes were associated with poorer overall cognition (g = -0.18), as well as slightly lower performance in memory (g = -0.27).
We found that type 1 diabetes was associated with cognitive dysfunction characterized by a lowered intelligence, diminished attention and a slowing of psychomotor speed. Glycemic extremes, which are described as a period of high glucose levels and severe hypoglycemia, were related to cognitive dysfunction in children with type 1 diabetes.
目的/引言：研究 1 型糖尿病患儿认知功能障碍的严重程度和模式，以及与其他疾病变量（如糖尿病早期发病、严重低血糖和高血糖）相关的可能影响。
我们根据系统评价和荟萃分析的首选报告项目指南进行了荟萃分析。我们搜索了 MedLine、Embase 和 PsycINFO，以确定截至 2016 年 9 月 30 日发表的关于 1 型糖尿病患儿认知功能的研究。使用组间标准化均数差值（即 Hedges'g）计算效应量，以量化糖尿病组患儿认知功能障碍的程度。
共有 19 项研究符合纳入标准，共纳入 1355 例 1 型糖尿病患儿和 696 例对照。与非糖尿病对照组相比，1 型糖尿病患儿的整体认知表现明显较差（g=-0.46），全面智力（g=-1.06）、注意力（g=-0.60）和心理运动速度（g=-0.46）也存在特定缺陷。血糖极端与整体认知较差（g=-0.18）相关，与记忆表现略低（g=-0.27）相关。
我们发现 1 型糖尿病与认知功能障碍相关，其特征为智力降低、注意力下降和心理运动速度减慢。血糖极端（即高血糖水平和严重低血糖的时期）与 1 型糖尿病患儿的认知功能障碍有关。
