Glycemic extremes are related to cognitive dysfunction in children with type 1 diabetes: A meta‐analysis

摘要

Aims/Introduction To examine the magnitude and pattern of cognitive dysfunction in children with type 1 diabetes, and the possible effects associated with other disease variables, such as early onset diabetes, severe hypoglycemia and hyperglycemia. Materials and Methods We carried out a meta‐analysis using the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines. We searched MedLine, Embase and PsycINFO to identify studies on cognitive function in children with type 1 diabetes that were published up until 30 September 2016. Effect sizes understood as the standardized mean differences between groups with diabetes and control groups (i.e., Hedges’ g ) were calculated to quantify the extent of cognitive dysfunction in those groups consisting of children with diabetes. Results A total of 19 studies met our inclusion criteria, comprising 1,355 participants with type 1 diabetes and 696 controls. Compared with non‐diabetic controls, children with type 1 diabetes showed a significantly poorer cognitive performance overall ( g =??0.46), as well as specific deficits in full‐scale intelligence ( g =??1.06), attention ( g =??0.60) and psychomotor speed ( g =??0.46). Glycemic extremes were associated with poorer overall cognition ( g =??0.18), as well as slightly lower performance in memory ( g =??0.27). Conclusions We found that type 1 diabetes was associated with cognitive dysfunction characterized by a lowered intelligence, diminished attention and a slowing of psychomotor speed. Glycemic extremes, which are described as a period of high glucose levels and severe hypoglycemia, were related to cognitive dysfunction in children with type 1 diabetes.