Cognitive Function Is Disrupted by Both Hypo- and Hyperglycemia in School-AgedChildren With Type 1 Diabetes: A Field Study

• DOI: 10.2337/dc08-1722
• Publication Date: 2009-03-27T00:45:21Z
• Authors: Linda A. Gonder-F...; John F. Zrebiec; Andrea U. Bauchowitz; LeeM. Ritterband; Joshua C. Magee; Daniel J. Cox; William L. Clarke
• Keywords: Glycated Hemoglobin; Male; education; Psychological Tests; clinical care; 610; Motor Activity; Hypoglycemia; 03 medical and health sciences; nutrition; psychosocial research; Diabetes Mellitus, Type 1; 0302 clinical medicine; Hyperglycemia; Reaction Time; Humans; Female; Child; Cognition Disorders; Mathematics; Original Research

OBJECTIVE We developed a field procedure using personal digital assistant (PDA) technology to test the hypothesis that naturally occurring episodes of hypo- and hyperglycemia are associated with deterioration in cognitive function children type 1 diabetes. RESEARCH DESIGN AND METHODS A total 61 aged 6–11 years diabetes received PDA programmed two brief tests (mental math choice reaction time), which they completed just before home glucose readings. The computer recorded time complete each number correct responses. Children several trials per day over 4–6 weeks for 70 trials. Performance variables were compared across ranges. Individual impairment scores (IISs) also computed child by calculating SD between performance during euglycemia extremes. RESULTS Time both mental was significantly longer hypoglycemia. During hyperglycemia, marginally significant (P = 0.053). There no differences on task accuracy. Decline equivalent at levels <3.0 >22.2 mmol/l. IISs varied greatly children, age or sex differences. CONCLUSIONS decrease efficiency occurs hyperglycemic fluctuations diabetes, this effect can be detected technology. With blood mmol/l, equals