Diabetic ketoacidosis and cognitive impairment in children and adolescents

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
K. Sh. Magomedova, Yu. V. Bykov, V. A. Baturin
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Abstract

The aim of the literature review was to highlight modern scientific sources on the formation and clinical manifestations of cognitive impairment in children and adolescents with type 1 diabetes mellitus (DM) after diabetic ketoacidosis (DKA). Type 1 DM is one of the most prevalent endocrine disorders in childhood and adolescence. DKA is the most common acute complication of type 1 DM that may cause cognitive impairment. Cerebral edema is the main cause of cerebral vascular insufficiency in patients with DKA. However, the mechanisms underlying the development of cognitive dysfunction in DKA have not been fully elucidated. The leading hypotheses include development of neuroinflammation, oxidative stress, disruption of neurogenesis, and neurodegeneration. Hypoxic – ischemic injury and changes in the brain neuroanatomy may also cause cognitive dysfunction. Disruption of some brain structures has been reported after DKA episodes, primarily affecting the white matter. Clinical studies in the pediatric population support the presence of a correlation between the severity and frequency of DKA and the severity of cognitive impairment. Cognitive dysfunction in children and adolescents after a DKA episode can manifest through decreased attention, impaired memory and executive function, and reduced IQ. The earliest possible diagnosis of cognitive impairment in pediatric patients with symptoms of DKA in the context of type 1 DM can improve the treatment prognosis for this endocrinopathy.
儿童和青少年糖尿病酮症酸中毒与认知障碍
本文综述了儿童和青少年1型糖尿病(DM)酮症酸中毒(DKA)后认知功能障碍的形成和临床表现的现代科学资料。1型糖尿病是儿童和青少年最常见的内分泌疾病之一。DKA是1型糖尿病最常见的急性并发症,可引起认知障碍。脑水肿是DKA患者脑血管功能不全的主要原因。然而,DKA中认知功能障碍发展的机制尚未完全阐明。主要的假设包括神经炎症、氧化应激、神经发生破坏和神经变性的发展。缺氧缺血性损伤和脑神经解剖结构的改变也可引起认知功能障碍。据报道,DKA发作后一些脑结构破坏,主要影响白质。儿科人群的临床研究支持DKA的严重程度和频率与认知障碍的严重程度之间存在相关性。儿童和青少年DKA发作后的认知功能障碍可表现为注意力下降、记忆和执行功能受损以及智商下降。在1型糖尿病合并DKA症状的儿童患者中,尽早诊断出认知功能障碍可以改善这种内分泌病的治疗预后。
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来源期刊
Byulleten Sibirskoy Meditsiny
Byulleten Sibirskoy Meditsiny MEDICINE, GENERAL & INTERNAL-
CiteScore
0.70
自引率
50.00%
发文量
102
审稿时长
8 weeks
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