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胰岛素对中枢神经系统的影响:对儿科1型糖尿病神经并发症及管理的见解。

The effect of insulin on the central nervous system: insights into neurological complications and management of type 1 diabetes in the pediatric population.

作者信息

Świątek Łukasz, Jeske Jan, Miedziaszczyk Miłosz, Idasiak-Piechocka Ilona, Wais Paulina

机构信息

Students' Scientific Section of Transplantation and Kidney Diseases. Department of General and Transplant Surgery, Poznan University of Medical Sciences, Poland.

Students' Scientific Section of Vascular Surgery, Poznan University of Medical Sciences, Poland.

出版信息

Pediatr Endocrinol Diabetes Metab. 2025;31(2):68-74. doi: 10.5114/pedm.2025.152597.

DOI:10.5114/pedm.2025.152597
PMID:40755345
Abstract

INTRODUCTION

Insulin is primarily known for its role in glucose homeostasis regulation. Since the discovery that insulin crosses the blood-brain barrier (BBB) in the year 1954, the influence of insulin on the central nervous system (CNS) has been under continuous research.

AIM OF THE STUDY

The aim of this paper is to review the current knowledge about the effects of insulin on CNS function in the pediatric population with special attention to diabetes type 1.

MATERIAL AND METHODS

The PubMed and Cochrane search engines were used in the data searching process.

CONCLUSIONS

Recent studies have shown that insulin has substantial glycemic and non-glycemic effects on the human brain. In pediatric populations, insulin's non-glycemic effects on CNS function are of particular interest due to the critical role of insulin in brain development, cognitive maturation, and learning. Therefore, children and adolescents with diabetes type 1 (T1DM), resulting in insulin deficiency and dysregulated glucose metabolism, require special attention.

CONCLUSIONS

While insulin therapy is essential for glycemic control in pediatric patients with T1DM, researchers suggest that insulin also has a crucial effect on the central nervous system (CNS), which may have implications for neurodevelopment and cognitive function in this group of patients.

摘要

引言

胰岛素主要因其在葡萄糖稳态调节中的作用而闻名。自1954年发现胰岛素可穿过血脑屏障(BBB)以来,胰岛素对中枢神经系统(CNS)的影响一直在持续研究中。

研究目的

本文旨在回顾目前关于胰岛素对儿科人群中枢神经系统功能影响的知识,特别关注1型糖尿病。

材料与方法

在数据搜索过程中使用了PubMed和Cochrane搜索引擎。

结论

最近的研究表明,胰岛素对人类大脑有显著的血糖和非血糖作用。在儿科人群中,由于胰岛素在大脑发育、认知成熟和学习中的关键作用,胰岛素对中枢神经系统功能的非血糖作用尤其令人关注。因此,患有1型糖尿病(T1DM)导致胰岛素缺乏和葡萄糖代谢失调的儿童和青少年需要特别关注。

结论

虽然胰岛素治疗对于儿科1型糖尿病患者的血糖控制至关重要,但研究人员表明,胰岛素对中枢神经系统(CNS)也有至关重要的影响,这可能对该组患者的神经发育和认知功能产生影响。

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本文引用的文献

1
Guidelines of the Polish Society of Pediatric Endocrinology and Diabetology and Pediatric Section of Diabetes Poland on insulin therapy using hybrid closed-loop systems in children and adolescents with diabetes in Poland.波兰儿科内分泌学和糖尿病学会以及波兰糖尿病儿科分会关于在波兰使用混合闭环系统为儿童和青少年糖尿病患者进行胰岛素治疗的指南。
Pediatr Endocrinol Diabetes Metab. 2024;30(3):132-147. doi: 10.5114/pedm.2024.144041.
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Depressive and anxiety symptoms in adolescents with type 1 diabetes - a single-centre observational study.1型糖尿病青少年的抑郁和焦虑症状——一项单中心观察性研究。
Pediatr Endocrinol Diabetes Metab. 2023;29(4):231-236. doi: 10.5114/pedm.2023.133121.
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使用连续血糖监测仪管理1型糖尿病:进展、挑战与建议。
Pharmgenomics Pers Med. 2023 Mar 31;16:263-276. doi: 10.2147/PGPM.S374663. eCollection 2023.
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Association between type 1 diabetes and neurodevelopmental disorders in children and adolescents: A systematic review and meta-analysis.1型糖尿病与儿童及青少年神经发育障碍之间的关联:一项系统评价和荟萃分析。
Front Psychiatry. 2022 Nov 22;13:982696. doi: 10.3389/fpsyt.2022.982696. eCollection 2022.
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The relationship between diabetes mellitus and attention deficit hyperactivity disorder: A systematic review and meta-analysis.糖尿病与注意力缺陷多动障碍之间的关系:一项系统评价与荟萃分析。
Front Pediatr. 2022 Sep 29;10:936813. doi: 10.3389/fped.2022.936813. eCollection 2022.
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Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study.2021 年全球 1 型糖尿病发病率、患病率和死亡率,并预测至 2040 年:一项建模研究。
Lancet Diabetes Endocrinol. 2022 Oct;10(10):741-760. doi: 10.1016/S2213-8587(22)00218-2. Epub 2022 Sep 13.
7
A Pilot randomized trial to examine effects of a hybrid closed-loop insulin delivery system on neurodevelopmental and cognitive outcomes in adolescents with type 1 diabetes.一项旨在检验混合闭环胰岛素输送系统对 1 型糖尿病青少年神经发育和认知结果影响的随机临床试验。
Nat Commun. 2022 Aug 30;13(1):4940. doi: 10.1038/s41467-022-32289-x.
8
Assessing depressive symptoms and diabetes distress in Type 1 diabetic adults: A comparison of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) users.评估 1 型糖尿病成人的抑郁症状和糖尿病困扰:连续皮下胰岛素输注 (CSII) 和多次每日注射 (MDI) 用户的比较。
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Trends Neurosci. 2022 May;45(5):384-400. doi: 10.1016/j.tins.2022.03.001. Epub 2022 Mar 28.
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Front Synaptic Neurosci. 2022 Jan 31;14:833449. doi: 10.3389/fnsyn.2022.833449. eCollection 2022.