Northam E A, Anderson P J, Werther G A, Warne G L, Adler R G, Andrewes D
Department of Psychology, Royal Children's Hospital, Melbourne, Australia.
Diabetes Care. 1998 Mar;21(3):379-84. doi: 10.2337/diacare.21.3.379.
To compare the neuropsychological profiles of children with IDDM with a community control group at two time points: 3 months after disease onset and 2 years after the baseline assessment.
A total of 123 children (age 3-14 years) with recent IDDM onset were compared with 129 community control subjects, stratified for age and sex, on standardized measures of general intelligence, attention, speed of processing, memory, learning, executive skills, and behavioral adjustment soon after diagnosis and 2 years later. Exclusion criteria were premorbid evidence of central nervous system disease or trauma, or English not spoken in the home.
There were no differences between children with IDDM and control subjects on any measure at the initial assessment 3 months after disease onset. Two years later, children with IDDM tended to show a less positive change, relative to control subjects, in their standardized scores on measures of general intelligence, and significantly so on the vocabulary (P < 0.01) and block design (P < 0.05) subtests. Multivariate group differences were also apparent on speed of processing (P < 0.05) and learning (P < 0.01) subtests, reflecting smaller developmental gains in the children with IDDM when compared with control subjects.
The findings are consistent with previous reports, suggesting that IDDM is associated with an increased risk of mild neuropsychological dysfunction. The skills most affected in this cohort were information processing speed, acquisition of new knowledge, and conceptual reasoning abilities. Clinicians and educators should be made aware of the risk of specific neuropsychological deficits in children with IDDM.
比较患有胰岛素依赖型糖尿病（IDDM）的儿童与社区对照组在两个时间点的神经心理学特征：疾病发作后3个月以及基线评估后2年。
共123名近期发病的IDDM儿童（年龄3 - 14岁）与129名社区对照受试者进行比较，后者按年龄和性别分层，在诊断后不久及2年后接受一般智力、注意力、处理速度、记忆、学习、执行技能和行为调整的标准化测量。排除标准为病前有中枢神经系统疾病或创伤的证据，或家中不讲英语。
在疾病发作后3个月的初次评估中，IDDM儿童与对照受试者在任何测量指标上均无差异。两年后，相对于对照受试者，IDDM儿童在一般智力测量指标上的标准化分数变化不太积极，在词汇（P < 0.01）和积木图案（P < 0.05）子测试中差异显著。在处理速度（P < 0.05）和学习（P < 0.01）子测试中也存在多变量组间差异，这表明与对照受试者相比，IDDM儿童的发育进步较小。
研究结果与先前报告一致，表明IDDM与轻度神经心理功能障碍风险增加有关。该队列中受影响最大的技能是信息处理速度、新知识获取和概念推理能力。临床医生和教育工作者应意识到IDDM儿童存在特定神经心理缺陷的风险。
