Cognitive function in Indonesian children with type 1 diabetes mellitus

IF 0.2 Q4 PEDIATRICS

Paediatrica Indonesiana Pub Date : 2024-02-23 DOI:10.14238/pi64.1.2024.44-50

Marselya Ulfa, Aditiawati Aditiawati, Yulisnawati Hasanah, Shafri Dhaini, Achirul Bakrie, R. M. Indra

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Abstract

Background Children with type 1 diabetes mellitus (T1DM) are at risk of cognitive impairment. While the pathophysiology is still unclear, cognitive impairment in children with T1DM can result in significant negative effects on quality of life. Objective to evaluate the cognitive function of Indonesian children with T1DM and its association with glycemic control and to identify factors affecting cognitive function in children with T1DM. Methods The cognitive function of children aged 6 years or older with T1DM was measured using the Wechsler Intelligence Scale for Children-Revised (WISC-R). We analyzed for potential associations between cognitive function and glycemic control based on mean HbA1c levels and other factors, such as the age of onset, duration of illness, and maternal educational attainment. We also identified failure to achieve age-appropriate results on any of the WISC-R subtests (cognitive impairment) and associated factors. Results A total of 46 subjects were included in this study, with a mean age of 12.8 (SD 3.4) years. There were 27 (58.7%) girls and 19 (41.3%) boys. Subjects’ mean full-scale IQ (FSIQ) was 91.35 (SD 11.43). A moderate negative correlation was found between FSIQ and mean HbA1c levels (r=-0.43; P<0.01). Children with mothers who had university degrees had significantly higher IQs (mean difference 7.39; 95%CI 3.10 to 13.66; P=0.02) than those with mothers without degrees. Failure of any WISC-R subtest was noted in 34 subjects, consisting of 17 verbal, 1 performance, and 34 verbal and performance subtests. A higher proportion of those with cognitive impairment had mean HbA1c >10%. However, compared to those with mean HbA1c ?10, the difference did not reach a statistical significance (OR 5.0; 95%CI 0.95 to 26.31; P=0.50) Conclusion Glycemic control and maternal educational attainment are associated with cognitive function in Indonesian children with T1DM. Poor glycemic control is also associated with a higher risk of cognitive impairment.

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印度尼西亚 1 型糖尿病儿童的认知功能

背景 1 型糖尿病（T1DM）患儿有认知障碍的风险。虽然病理生理学尚不清楚，但 T1DM 患儿的认知功能障碍会对生活质量造成严重的负面影响。目的评估印度尼西亚 T1DM 儿童的认知功能及其与血糖控制的关系，并确定影响 T1DM 儿童认知功能的因素。方法使用韦氏儿童智力量表修订版（WISC-R）测量 6 岁或以上 T1DM 儿童的认知功能。我们根据平均 HbA1c 水平和其他因素（如发病年龄、病程和母亲受教育程度）分析了认知功能与血糖控制之间的潜在关联。我们还确定了未能在 WISC-R 的任何一项分测验中取得与年龄相符的成绩（认知障碍）及其相关因素。结果本研究共纳入 46 名受试者，平均年龄为 12.8 岁（标准差 3.4）。其中女孩 27 人（58.7%），男孩 19 人（41.3%）。受试者的平均全面智商（FSIQ）为 91.35（标准差 11.43）。FSIQ 与平均 HbA1c 水平呈中度负相关（r=-0.43；P10%）。然而，与 HbA1c 平均值为 10 的儿童相比，两者之间的差异没有统计学意义（OR 5.0；95%CI 0.95 至 26.31；P=0.50）。血糖控制不佳也与认知障碍的风险较高有关。

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