Cognitive function following diabetic ketoacidosis in young children with type 1 diabetes.
Cognitive function following diabetic ketoacidosis in young children with type 1 diabetes.
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DOI：
10.1002/edm2.412
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发表时间：
2023-05
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患有1型糖尿病（T1 D）的幼儿可能在糖尿病酮症酸中毒（DKA）后认知能力下降的风险特别高。然而，T1 D的认知功能研究通常检查学龄儿童。本研究的目的是检查DKA的单一经历是否与幼儿认知功能低下有关。我们发现，最近诊断的3至5岁奥尔兹经历了一次DKA发作，无论其严重程度如何，其IQ评分均低于未接触DKA的儿童。我们前瞻性入组了46名3至5岁的儿童，他们在T1 D发作时出现DKA，参加了一项随机多中心临床试验，评价DKA治疗的静脉输液方案。22名儿童的DKA为中度/重度，24名儿童为轻度。在DKA发作后2-6个月评估一次神经认知功能。还评估了27名T1 D儿童（但无DKA暴露）的对照组。在神经认知测试时，患者组的年龄和T1 D持续时间相匹配。经历过DKA的儿童，无论其严重程度如何，其IQ评分均显著低于未经历DKA的儿童，F（2，70）= 6.26，p = .003，部分η 2 = .15。在考虑了社会经济地位和种族之后，这种影响仍然存在。单次DKA发作与幼儿暴露于DKA后不久的较低智商评分相关。患有1型糖尿病的幼儿在糖尿病酮症酸中毒（DKA）后认知功能下降的风险特别高，但1型糖尿病的认知功能研究通常检查学龄儿童。这项研究的目的是检查是否一个单一的经验DKA与幼儿认知功能低下。我们发现，最近诊断的3至5岁奥尔兹经历了一次DKA发作，无论其严重程度如何，其IQ均低于年龄匹配的无DKA暴露的患者组。
Young children with type 1 diabetes (T1D) may be at particularly high risk of cognitive decline following diabetic ketoacidosis (DKA). However, studies of cognitive functioning in T1D typically examine school‐age children. The goal of this study was to examine whether a single experience of DKA is associated with lower cognitive functioning in young children. We found that recently diagnosed 3‐ to 5‐year‐olds who experienced one DKA episode, regardless of its severity, exhibited lower IQ scores than those with no DKA exposure. We prospectively enrolled 46 3‐ to 5‐year‐old children, who presented with DKA at the onset of T1D, in a randomized multi‐site clinical trial evaluating intravenous fluid protocols for DKA treatment. DKA was moderate/severe in 22 children and mild in 24 children. Neurocognitive function was assessed once 2–6 months after the DKA episode. A comparison group of 27 children with T1D, but no DKA exposure, was also assessed. Patient groups were matched for age and T1D duration at the time of neurocognitive testing. Children who experienced DKA, regardless of its severity, exhibited significantly lower IQ scores than children who did not experience DKA, F(2, 70) = 6.26, p = .003, partial η 2 = .15. This effect persisted after accounting for socioeconomic status and ethnicity. A single DKA episode is associated with lower IQ scores soon after exposure to DKA in young children. Young children with Type‐1 Diabetes may be at particularly high risk of cognitive decline following diabetic ketoacidosis (DKA), but studies of cognitive functioning in Type 1 diabetes typically examine school‐age children. The goal of the study was to examine whether a single experience DKA is associated with lower cognitive functioning in young children. We found that recently diagnosed 3‐to 5‐year‐olds who experienced one DKA episode, regardless of its severity, exhibited lower IQ than an age‐ matched group of patients with no DKA exposure.