Department of Psychology, University of California, Davis, Davis, California, USA.
Center for Mind and Brain, University of California, Davis, Davis, California, USA.
Endocrinol Diabetes Metab. 2023 May;6(3):e412. doi: 10.1002/edm2.412. Epub 2023 Feb 14.
Young children with type 1 diabetes (T1D) may be at particularly high risk of cognitive decline following diabetic ketoacidosis (DKA). However, studies of cognitive functioning in T1D typically examine school-age children. The goal of this study was to examine whether a single experience of DKA is associated with lower cognitive functioning in young children. We found that recently diagnosed 3- to 5-year-olds who experienced one DKA episode, regardless of its severity, exhibited lower IQ scores than those with no DKA exposure.
We prospectively enrolled 46 3- to 5-year-old children, who presented with DKA at the onset of T1D, in a randomized multi-site clinical trial evaluating intravenous fluid protocols for DKA treatment. DKA was moderate/severe in 22 children and mild in 24 children. Neurocognitive function was assessed once 2-6 months after the DKA episode. A comparison group of 27 children with T1D, but no DKA exposure, was also assessed. Patient groups were matched for age and T1D duration at the time of neurocognitive testing.
Children who experienced DKA, regardless of its severity, exhibited significantly lower IQ scores than children who did not experience DKA, F(2, 70) = 6.26, p = .003, partial η = .15. This effect persisted after accounting for socioeconomic status and ethnicity.
A single DKA episode is associated with lower IQ scores soon after exposure to DKA in young children.
患有 1 型糖尿病（T1D）的幼儿在经历糖尿病酮症酸中毒（DKA）后，认知能力下降的风险可能特别高。然而，关于 T1D 认知功能的研究通常针对学龄儿童。本研究的目的是研究单次 DKA 是否与幼儿认知功能下降有关。我们发现，最近被诊断出患有 T1D 的 3 至 5 岁儿童，无论 DKA 的严重程度如何，其智商评分均低于未发生 DKA 暴露的儿童。
我们前瞻性地招募了 46 名 3 至 5 岁的儿童，这些儿童在 T1D 发病时出现 DKA，参与了一项评估 DKA 治疗静脉输液方案的多中心随机临床试验。22 名儿童患有中度/重度 DKA，24 名儿童患有轻度 DKA。在 DKA 发作后 2-6 个月，对神经认知功能进行了评估。还评估了一组 27 名患有 T1D 但未发生 DKA 暴露的儿童作为对照组。在进行神经认知测试时，根据年龄和 T1D 持续时间对患者组进行匹配。
无论 DKA 的严重程度如何，经历过 DKA 的儿童的智商评分明显低于未经历过 DKA 的儿童，F(2, 70) = 6.26, p = 0.003, 部分 η² = 0.15。在考虑社会经济地位和种族后，这一效应仍然存在。
在幼儿中，单次 DKA 发作与暴露于 DKA 后不久的智商评分较低有关。
