Ryan C M
Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213.
Diabetes Care. 1988 Jan;11(1):86-93. doi: 10.2337/diacare.11.1.86.
There is increasing interest in the possibility that diabetes mellitus may be associated with a series of neurobehavioral, or neuropsychological, changes; i.e., learning, memory, problem solving, mental and motor speed, and eye-hand coordination may sometimes be disrupted in diabetic children and adults, and this disruption may be a consequence of certain disease-related variables. To date, four neurobehavioral risk factors have been identified. For children and adolescents, the most potent risk factors appear to be age at diagnosis and the occurrence of schoolroom-related problems. Children who develop diabetes early in life are more likely to show serious cognitive impairments on virtually all measures. In addition, diabetic children with school attendance problems tend to score lower than expected on verbal IQ tests and school achievement tests. For adults, the most carefully studied risk factor is degree of metabolic control. Adults in poor control are far more likely to manifest subtle changes on measures of mental efficiency. This may be particularly evident on tasks that require the development and deployment of sophisticated information-processing strategies. A fourth variable--severe episodes of hypoglycemia--is known to disrupt functioning in diabetic subjects of any age, although it has not yet been studied systematically in large-scale studies. Indeed, because virtually all extant studies have been based on limited neurobehavioral and biomedical assessments of relatively few volunteer subjects, this list of risk factors must be considered tentative at best.
糖尿病可能与一系列神经行为或神经心理变化有关，这种可能性正引起越来越多的关注；也就是说，糖尿病儿童和成人的学习、记忆、解决问题的能力、思维和运动速度以及手眼协调能力有时可能会受到干扰，而这种干扰可能是某些与疾病相关的变量导致的。迄今为止，已经确定了四个神经行为风险因素。对于儿童和青少年来说，最主要的风险因素似乎是诊断时的年龄以及与学校相关问题的出现。幼年患糖尿病的儿童在几乎所有测试中都更有可能表现出严重的认知障碍。此外，有上学出勤问题的糖尿病儿童在语言智商测试和学业成绩测试中的得分往往低于预期。对于成年人来说，研究最深入的风险因素是代谢控制程度。代谢控制不佳的成年人在心理效率测试中更有可能表现出细微变化。这在需要制定和运用复杂信息处理策略的任务中可能尤为明显。第四个变量——严重低血糖发作——已知会干扰任何年龄段糖尿病患者的功能，尽管尚未在大规模研究中进行系统研究。事实上，由于几乎所有现有研究都基于对相对较少志愿者受试者的有限神经行为和生物医学评估，这份风险因素清单充其量只能算是初步的。
