儿童 1 型糖尿病的大脑健康：风险和保护因素。
Brain Health in Children with Type 1 Diabetes: Risk and Protective Factors.
机构信息
Department of Pediatrics, Vanderbilt University Medical Center, 2525 West End Ave., Suite 1200, Nashville, TN, 37203, USA.
Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
Curr Diab Rep. 2021 Mar 14;21(4):12. doi: 10.1007/s11892-021-01380-w.
Abstract
PURPOSE OF REVIEW
To synthesize findings from studies of neurocognitive complications in children with type 1 diabetes (T1D) and highlight potential risk and protective factors.
RECENT FINDINGS
Emerging evidence suggests that hyperglycemia and time in range may be more important for brain development than episodes of hypoglycemia. Further, diabetic ketoacidosis (DKA) at the time of T1D diagnosis appears to be a particular risk factor for neurocognitive complications, particularly deficits in executive function skills and memory, with differences in cerebral white matter microstructure seen via advanced magnetic resonance imaging methods, and lower scores on measures of attention and memory observed among children who were diagnosed in DKA. Other factors that may influence neurocognitive development include child sleep, caregiver distress, and diabetes device use, presumably due to improved glycemic control. We highlight neurocognitive risk and protective factors for children with T1D and priorities for future research in this high-risk population.
摘要
目的综述
综合研究 1 型糖尿病（T1D）儿童神经认知并发症的结果，并强调潜在的风险和保护因素。
最新发现
新出现的证据表明，高血糖和血糖控制范围比低血糖发作对大脑发育更为重要。此外，T1D 诊断时的糖尿病酮症酸中毒（DKA）似乎是神经认知并发症的一个特殊风险因素，特别是在执行功能技能和记忆方面存在缺陷，通过先进的磁共振成像方法可以观察到大脑白质微观结构的差异，在 DKA 确诊的儿童中观察到注意力和记忆测试分数较低。可能影响神经认知发育的其他因素包括儿童睡眠、照顾者的困扰和糖尿病设备的使用，这可能是由于血糖控制得到改善。我们强调了 T1D 儿童的神经认知风险和保护因素，以及该高危人群未来研究的重点。
相似文献
1
Brain Health in Children with Type 1 Diabetes: Risk and Protective Factors.儿童 1 型糖尿病的大脑健康：风险和保护因素。
Curr Diab Rep. 2021 Mar 14;21(4):12. doi: 10.1007/s11892-021-01380-w.
2
Recurrent diabetic ketoacidosis and cognitive function among older adults with type 1 diabetes: findings from the Study of Longevity in Diabetes.1 型糖尿病老年患者中反复发生的糖尿病酮症酸中毒与认知功能：来自糖尿病长寿研究的结果。
BMJ Open Diabetes Res Care. 2020 Jun;8(1). doi: 10.1136/bmjdrc-2020-001173.
3
Cognitive Function Following Diabetic Ketoacidosis in Children With New-Onset or Previously Diagnosed Type 1 Diabetes.新发或既往诊断为1型糖尿病的儿童糖尿病酮症酸中毒后的认知功能
Diabetes Care. 2020 Nov;43(11):2768-2775. doi: 10.2337/dc20-0187. Epub 2020 Sep 22.
4
10-Year Incidence of Diabetic Ketoacidosis at Type 1 Diabetes Diagnosis in Children Aged Less Than 16 Years From a Large Regional Center (Hangzhou, China).中国杭州大型区域中心 16 岁以下儿童 1 型糖尿病诊断时糖尿病酮症酸中毒的 10 年发生率。
Front Endocrinol (Lausanne). 2021 Apr 27;12:653519. doi: 10.3389/fendo.2021.653519. eCollection 2021.
5
Using population data to understand the epidemiology and risk factors for diabetic ketoacidosis in Australian children with type 1 diabetes.利用人群数据了解澳大利亚 1 型糖尿病儿童糖尿病酮症酸中毒的流行病学和危险因素。
Pediatr Diabetes. 2019 Nov;20(7):901-908. doi: 10.1111/pedi.12891. Epub 2019 Jul 16.
6
Diabetic ketoacidosis in children newly diagnosed with type 1 diabetes mellitus: Role of demographic, clinical, and biochemical features along with genetic and immunological markers as risk factors. A 20-year experience in a tertiary Belgian center.儿童新诊断 1 型糖尿病酮症酸中毒：人口统计学、临床和生化特征以及遗传和免疫标志物作为危险因素的作用。比利时一家三级中心 20 年的经验。
Pediatr Diabetes. 2019 Aug;20(5):584-593. doi: 10.1111/pedi.12864. Epub 2019 May 15.
7
The Impact of Hypo- and Hyperglycemia on Cognition and Brain Development in Young Children with Type 1 Diabetes.1 型糖尿病患儿低血糖和高血糖对认知和大脑发育的影响。
Horm Res Paediatr. 2021;94(3-4):115-123. doi: 10.1159/000517352. Epub 2021 Jul 9.
8
Multicentre analysis of hyperglycaemic hyperosmolar state and diabetic ketoacidosis in type 1 and type 2 diabetes.1 型和 2 型糖尿病患者高血糖高渗状态和糖尿病酮症酸中毒的多中心分析。
Acta Diabetol. 2020 Oct;57(10):1245-1253. doi: 10.1007/s00592-020-01538-0. Epub 2020 Jun 2.
9
Neurological consequences of diabetic ketoacidosis at initial presentation of type 1 diabetes in a prospective cohort study of children.一项针对儿童的前瞻性队列研究中1型糖尿病初发时糖尿病酮症酸中毒的神经学后果
Diabetes Care. 2014 Jun;37(6):1554-62. doi: 10.2337/dc13-1904.
10
Ketoacidosis at diagnosis of type 1 diabetes in French children and adolescents.法国儿童和青少年1型糖尿病确诊时的酮症酸中毒
Diabetes Metab. 2014 Apr;40(2):137-42. doi: 10.1016/j.diabet.2013.11.001. Epub 2013 Dec 11.
引用本文的文献
1
Type 1 diabetes and its complications affect preeclampsia: A Mendelian randomization analysis.1型糖尿病及其并发症影响子痫前期：一项孟德尔随机化分析。
Medicine (Baltimore). 2025 Sep 5;104(36):e44415. doi: 10.1097/MD.0000000000044415.
2
Cognitive flexibility is associated with the age of onset and duration among patients with type 1 diabetes.认知灵活性与1型糖尿病患者的发病年龄和病程有关。
Sci Rep. 2025 Jul 7;15(1):24222. doi: 10.1038/s41598-025-99678-2.
3
Intervention to reduce barriers to type 1 diabetes self-management: Diabetes Journey study design and participant characteristics.减少1型糖尿病自我管理障碍的干预措施：糖尿病历程研究设计与参与者特征
Contemp Clin Trials. 2025 May;152:107849. doi: 10.1016/j.cct.2025.107849. Epub 2025 Feb 20.
4
Online diabetes self-management education application for reducing glycated hemoglobin level among patients with type 1 diabetes mellitus: a systematic review and meta-analysis.用于降低1型糖尿病患者糖化血红蛋白水平的在线糖尿病自我管理教育应用程序：一项系统评价和荟萃分析。
Clin Diabetes Endocrinol. 2024 Dec 17;10(1):48. doi: 10.1186/s40842-024-00201-9.
5
Safety and Efficacy of Using Advanced Hybrid Closed Loop Off-Label in an Infant Diagnosed with Permanent Neonatal Diabetes Mellitus: A Case Report and a Look to the Future.在一名被诊断为永久性新生儿糖尿病的婴儿中使用先进的非标签混合闭环系统的安全性和有效性：一例病例报告及对未来的展望
Children (Basel). 2024 Oct 9;11(10):1225. doi: 10.3390/children11101225.
6
Three months use of Hybrid Closed Loop Systems improves glycated hemoglobin levels in adolescents and children with type 1 diabetes: A meta-analysis.三个月使用混合闭环系统可改善 1 型糖尿病青少年和儿童的糖化血红蛋白水平：一项荟萃分析。
PLoS One. 2024 Aug 12;19(8):e0308202. doi: 10.1371/journal.pone.0308202. eCollection 2024.
7
Using Community Engagement Methods to Guide Study Protocol Decisions for School-Aged Children With Type 1 Diabetes.运用社区参与方法指导1型糖尿病学龄儿童的研究方案决策
Diabetes Spectr. 2024 Winter;37(1):95-99. doi: 10.2337/ds23-0018. Epub 2023 Sep 8.
8
The relationship between diabetic ketoacidosis and suicidal or self-injurious behaviour: A systematic review.糖尿病酮症酸中毒与自杀或自伤行为之间的关系：一项系统综述。
J Clin Transl Endocrinol. 2023 Sep 29;34:100325. doi: 10.1016/j.jcte.2023.100325. eCollection 2023 Dec.
9
Cognitive disengagement syndrome in children with type 1 diabetes: important implications for clinical outcomes.1 型糖尿病患儿的认知脱离综合征：对临床结局的重要影响。
Acta Diabetol. 2024 Jan;61(1):53-61. doi: 10.1007/s00592-023-02178-w. Epub 2023 Sep 6.
10
Differential Cortical Volume and Surface Morphometry in Youth With Chronic Health Conditions.慢性健康状况青少年的皮质体积和表面形态计量学差异。
Biol Res Nurs. 2024 Jan;26(1):115-124. doi: 10.1177/10998004231195294. Epub 2023 Aug 14.
本文引用的文献
1
Pilot Trial of a Sleep-Promoting Intervention for Children With Type 1 Diabetes.1 型糖尿病儿童睡眠促进干预的初步试验。
J Pediatr Psychol. 2021 Mar 18;46(3):304-313. doi: 10.1093/jpepsy/jsaa105.
2
Cognitive evaluation in cerebral small vessel disease: towards an evidence-based identification of the reference standards. Part 1. A systematic review and qualitative data synthesis.脑小血管病的认知评估：朝着基于证据的参考标准识别方法迈进。第 1 部分。系统综述和定性数据综合。
J Neurol. 2021 Dec;268(12):4563-4572. doi: 10.1007/s00415-020-10262-2. Epub 2020 Oct 13.
3
Cognitive Function Following Diabetic Ketoacidosis in Children With New-Onset or Previously Diagnosed Type 1 Diabetes.新发或既往诊断为1型糖尿病的儿童糖尿病酮症酸中毒后的认知功能
Diabetes Care. 2020 Nov;43(11):2768-2775. doi: 10.2337/dc20-0187. Epub 2020 Sep 22.
4
Functional Connectivity Decreases with Metabolic Stress in Sickle Cell Disease.镰状细胞病代谢应激时功能连接减少。
Ann Neurol. 2020 Nov;88(5):995-1008. doi: 10.1002/ana.25891. Epub 2020 Sep 16.
5
Disrupted Regional Cerebral Blood Flow in Children With Newly-Diagnosed Type 1 Diabetes Mellitus: An Arterial Spin Labeling Perfusion Magnetic Resonance Imaging Study.新诊断1型糖尿病患儿局部脑血流中断：一项动脉自旋标记灌注磁共振成像研究
Front Neurol. 2020 Jun 19;11:572. doi: 10.3389/fneur.2020.00572. eCollection 2020.
6
Abnormal Functional Connectivity Density in New-Onset Type 1 Diabetes Mellitus Children: A Resting-State Functional Magnetic Resonance Imaging Study.新诊断1型糖尿病患儿的异常功能连接密度：一项静息态功能磁共振成像研究
Front Psychiatry. 2020 Apr 17;11:284. doi: 10.3389/fpsyt.2020.00284. eCollection 2020.
7
Effects of Diabetic Ketoacidosis on Executive Function in Children With Type 1 Diabetes: Evidence From Wisconsin Card Sorting Test Performance.糖尿病酮症酸中毒对 1 型糖尿病儿童执行功能的影响：威斯康星卡片分类测验表现的证据。
Psychosom Med. 2020 May;82(4):359-365. doi: 10.1097/PSY.0000000000000797.
8
Young Children with Type 1 Diabetes: Sleep, Health-Related Quality of Life, and Continuous Glucose Monitor Use.1 型糖尿病儿童：睡眠、健康相关生活质量和连续血糖监测仪的使用。
Diabetes Technol Ther. 2020 Aug;22(8):639-642. doi: 10.1089/dia.2019.0437. Epub 2020 Mar 2.
9
Communication and coping intervention for mothers of adolescents with type 1 diabetes: Rationale and trial design.青少年 1 型糖尿病母亲的沟通和应对干预：基本原理和试验设计。
Contemp Clin Trials. 2019 Oct;85:105844. doi: 10.1016/j.cct.2019.105844. Epub 2019 Sep 6.
10
Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range.临床连续血糖监测数据解读目标：时间范围国际共识推荐意见。
Diabetes Care. 2019 Aug;42(8):1593-1603. doi: 10.2337/dci19-0028. Epub 2019 Jun 8.
Zotero 插件