COGNITIVE FUNCTIONS IN CHILDREN WITH TYPE I DIABETES

Awad Eldamom, Ahmed; Abd-Ellatif Afia, Ali; Abdul Fattah Alnabawy, Ali; Abdullah Elsayeh, Abdelsattar; Fathy Esmael, Nabil

doi:10.21608/azjp.2019.70259

COGNITIVE FUNCTIONS IN CHILDREN WITH TYPE I DIABETES

Document Type : Original Article

Authors

10.21608/azjp.2019.70259

Abstract

Background: Type 1 diabetes mellitus (T1DM) is a common chronic disease characterized by hyperglycemia as a cardinal biochemical feature caused by deficiency of insulin secretion due to pancreatic β-cell damage. T1DM is the most common endocrine-metabolic disorder of childhood and adolescence, with important consequences on physical and emotional development. There is increasing agreement that children with T1DM are at higher risk of developing slight cognitive disabilities compared to healthy age-matched peers.
Objectives: To quantify the magnitude and pattern of cognitive difficulties in pediatric type 1 diabetes as well as the effects associated with earlier disease onset and longer duration of diabetes.
Research design and methods: This is a case-control study. The study was conducted over a period from November 2016 to November 2018. Our study included fifty patients with T1DM matched with age and gender of fifty apparently healthy controls. All cases were subjected to history, clinical examination, investigations and cognitive functions which assessed by Modified Mini-Mental State examination (3MS), Intelligence Quotient (IQ) test and Pediatric Symptoms Checklist (PSC).
Results: The present study shows high significant differences between patients and control groups as regard to IQ, Modified Mini-Mental State examination (3MS) and Pediatric Symptoms Checklist (PSC). The best cut off point for IQ to detect cognitive dysfunction in diabetic patients was found ≤ 83 with sensitivity of 88%, specificity of 86% and area under curve (AUC) of 91.4. The best cut off point for 3MS to detect cognitive dysfunction in diabetic patients was found ≤ 27 with sensitivity of 58%, specificity of 76% and AUC of 74.4. Finally the best cut off point for PSC to detect cognitive dysfunction in diabetic patients was found ≤ 42 with sensitivity of 84%, specificity of 92% and AUC of 96.1%. The PSC was found the better predictor of cognitive dysfunction in diabetes with area under curve (AUC) 96.1% followed by IQ with AUC of 91.4% and lastly the 3MS with AUC of 74.4%.
Conclusion: From our study we concluded that diabetic children have lower cognitive performance than non- diabetic and those cognitive dysfunction increased in diabetic patient with disease duration >5 years and in those with poor glycemic control.

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