الفهرس 
TYPE 1 DIABETES MELLITUS
Type 1 Diabetes MellitusOnly 14 pages are availabe for public view
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Abstract
Objective: To assess the cognitive functions and academic
performance in children and adolescents with type 1 diabetes mellitus
(T1DM) and identify the most possible risk factors affecting them.
Methods: This is a cross sectional study of 90 children and
adolescents with T1DM attending Pediatric Diabetes Clinic, Children‟s
Hospital, Ain Shams University were classified into 3 matched groups as
follows: newly diagnosed, controlled and uncontrolled T1DM. All the
included patients were subjected to detailed medical history with especial
emphasis on the most possible risk factors affecting brain functions. An
IQ test using Wechsler intelligence scale for children (WISC) was
performed for all the 3 groups and overall academic grades were recorded,
based on the scores obtained in the main subjects (Arabic, English and
Mathematics).
Results: Total number of all patients (n=90); 30 in each group, their
mean age was 11.42 ± 3.50 years old with mean age at diagnosis was 7.57
± 3.42 years old and median duration of T1DM was 4 years with 10% of
the patients were admitted to the hospital by DKA. Comparison between
the 3 groups of type 1 diabetic patients according to diabetes-related
variables revealed that, patients with controlled T1DM were found to be
significantly the lowest HA1c level (mean 7.84 ± 1.5) (P-value = 0.000)
and the earliest age of diagnosis (mean 5.7 ± 2.95) ( P-value = 0.000) with
the longest duration of T1DM (median 5.5 years) (P-value = 0.000), they
got the best IQ test grades (P-value = 0.017) and academic grades (Pvalue
= 0.000) in all subjects compared with other groups of uncontrolled
and newly diagnosed type 1 diabetic patients. Analysis of the IQ and
academic grades in relation to the studied parameters revealed that; high
levels of HA1c are associated with cognitive and academic affection
rather than the age at diagnosis, duration of the disease and frequency of
hypoglycemia in children and adolescents with T1DM.
Conclusion: Metabolic derangements associated with T1DM affect
brain integrity in children and adolescents which in turn affect their
cognitive and academic functions. The most important risk factors are late
diagnosis, chronic hyperglycaemia and DKA occurrence.
Keywords: T1DM; Cognitive and Academic abilities.