Bjørgaas M, Gimse R, Vik T, Sand T
Department of Pediatrics, Trondheim University Hospital, Norway.
Acta Paediatr. 1997 Feb;86(2):148-53. doi: 10.1111/j.1651-2227.1997.tb08856.x.
We assessed the effect of diabetes and of episodes of severe hypoglycaemia on cognitive function in 28 diabetic children. Fifteen diabetic children (age 12.9 (SD 2.0) years) had experienced 1-4 episodes of severe hypoglycaemia. Five of these children diseased before the age of 5 years (SH-eod subgroup), and ten diseased after this age (SH-lod subgroup). Thirteen diabetic children (age 13.1 (SD 2.0) years) had not experienced episodes of severe hypoglycaemia (non-SH group). Each diabetic child was compared with a healthy control child of the same age and gender and with a similar social background. Neuropsychological assessment was blinded. The neuropsychological tests were grouped into one of seven cognitive domains. We found no effect on cognitive performance from diabetes per se or from severe hypoglycaemia in children with late-onset diabetes. However, early-onset diabetes was associated with low scores in two cognitive domains: psychomotor efficiency and attention. The SH-eod subgroup had lower scores than the SH-lod subgroup in psychomotor efficiency (p < 0.05) and also had lower scores than the SH-lod subgroup and the non-SH group in measures of attention (p < 0.05). Our results may indicate a slight cognitive dysfunction in children with early-onset diabetes who have experienced episodes of severe hypoglycaemia early in childhood.
我们评估了糖尿病及严重低血糖发作对28名糖尿病儿童认知功能的影响。15名糖尿病儿童（年龄12.9（标准差2.0）岁）经历过1 - 4次严重低血糖发作。其中5名儿童在5岁前患病（严重低血糖早发疾病亚组），10名在5岁后患病（严重低血糖晚发疾病亚组）。13名糖尿病儿童（年龄13.1（标准差2.0）岁）未经历过严重低血糖发作（非严重低血糖组）。将每名糖尿病儿童与年龄、性别相同且社会背景相似的健康对照儿童进行比较。神经心理学评估采用盲法。神经心理学测试分为七个认知领域之一。我们发现，迟发性糖尿病儿童的糖尿病本身或严重低血糖对认知表现均无影响。然而，早发性糖尿病与两个认知领域的低分相关：心理运动效率和注意力。严重低血糖早发疾病亚组在心理运动效率方面的得分低于严重低血糖晚发疾病亚组（p < 0.05），在注意力测量方面的得分也低于严重低血糖晚发疾病亚组和非严重低血糖组（p < 0.05）。我们的结果可能表明，早发性糖尿病且在儿童早期经历过严重低血糖发作的儿童存在轻微认知功能障碍。
