Executive function deficits in adults with childhood-onset type 1 diabetes mellitus: Evidence from Wisconsin card sorting test performance.

Abstract

Background: Executive functions (EFs) are important for the Type 1 diabetes mellitus (T1DM) self-care perspective. This study aimed to investigate whether patients with T1DM have poorer EFs than healthy controls (HCs) and whether there are differences in EFs between childhood-onset and adult-onset T1DM.

Methods: This study included 94, 110, and 100 participants with childhood-onset and adult-onset T1DM and HCs, respectively. All participants completed the Wisconsin Card Sorting Test to assess EFs. The Chinese version of the WAIS and BDI-II were performed to determine IQ and emotion in all participants.

Results: The childhood-onset group made lower scores of WCST total errors (P = 0.015), perseverative errors (P = 0.038) than the HC group, and the adult-onset group made lower scores of WCST total errors (P = 0.025) than the HC group. In the diabetes group, after controlling diabetes duration, the childhood-onset group made significantly higher scores of WCST total errors (P = 0.040), perseverative errors (P = 0.038), and non-perseverative errors (P = 0.013). In the childhood-onset group, perseverative errors were significantly associated with duration of T1DM (β = -0.24, t = -2.34, P = 0.021), and the history of severe hypoglycemia affects the non-perseverative errors(β = -0.26, t = -2.55, P = 0.013).

Conclusions: T1DM is associated with EF decrements, and there are differences in EFs between childhood-onset and adult-onset T1DM. These findings indicate that we should consider detecting and intervening in EF deficits in the T1DM population according to the age of onset.