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.
Curr Diab Rep. 2021 Mar 14;21(4):12. doi: 10.1007/s11892-021-01380-w.
To synthesize findings from studies of neurocognitive complications in children with type 1 diabetes (T1D) and highlight potential risk and protective factors.
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.
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。
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。
