Conventional versus intensive diabetes therapy in children with type 1 diabetes - Effects on memory and motor speed
Conventional versus intensive diabetes therapy in children with type 1 diabetes - Effects on memory and motor speed
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DOI：
10.2337/diacare.22.8.1318
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发表时间：
1999-08-01
期刊：
影响因子：
16.2
通讯作者：
Craft, S
中科院分区：
文献类型：
--
作者：
Hershey, T;Bhargava, N;Craft, S
目的 - 严重低血糖可能会损害内侧时间介导的认知技能，例如明确回忆过去事件的能力（延迟陈述性记忆）。本研究的目的是确定一组患有迟发性陈述性记忆缺陷的糖尿病儿童是否存在延迟性陈述性记忆缺陷。研究设计和方法 - 非糖尿病儿童 (n = 16) 和 I 型糖尿病儿童在诊断时被随机分配接受强化 (IT) (n = 13) 或常规 (CT) (n = 12) 糖尿病治疗，参与了这项研究。所有严重低血糖的发作均经过前瞻性确定。所有儿童都接受了与内侧颞叶功能密切相关的记忆任务和反应时间测量。 结果 - 我们的结果表明，与 CT 组或对照受试者相比，IT 组严重低血糖的发生率高出三倍，空间陈述性记忆任务的准确度较低，模式识别任务的执行速度较慢，但准确度不低。此外，与非糖尿病同龄人相比，两组 1 型糖尿病儿童在运动速度任务上均受到显着损害。 结论 - 这些结果表明与 IT 相关的选择性相对记忆障碍与严重低血糖和内侧颞叶损伤或功能障碍的影响一致。如果更大规模的前瞻性研究确定严重低血糖是这种记忆障碍的中介因素，那么在对年轻 I 型糖尿病患者实施过于严格的血糖控制标准时应格外小心，因为与 IT 方案相关的低血糖风险增加。
OBJECTIVE - Severe hypoglycemia may impair medial temporal-mediated cognitive skills, such as the ability to recall past events explicitly (delayed declarative memory). The objective of this study was to determine whether delayed declarative memory deficits are present in a group of diabetic children with an increased. risk of severe hypoglycemia.RESEARCH DESIGN AND METHODS - Nondiabetic children (n = 16) and children with type I diabetes who had been randomly assigned to either intensive (IT) (n = 13) or conventional (CT) (n = 12) diabetes therapy at the lime of diagnosis participated in the study. All episodes of severe hypoglycemia were prospectively ascertained. All children were tested on memory tasks that have been closely linked to medial temporal Functioning and on reaction time measures.RESULTS - Our results demonstrated that the IT group had a threefold higher rate of severe hypoglycemia, performed less accurately on a spatial declarative memory task, and performed more slowly but not less accurately, on a pattern recognition task than did the CT group or control subjects. In addition, both groups of type 1 diabetic children were significantly impaired on a motor speed task compared with their nondiabetic peers.CONCLUSIONS - These results indicate a selective relative memory impairment associated with IT that is consistent with the effects of severe hypoglycemia and medial temporal damage or dysfunction. If larger prospective studies determine that severe hypoglycemia is the mediating factor for this memory impairment, extreme caution in imposing overly strict standards for glucose control in young patients with type I diabetes would be indicated because of the increased risk of hypoglycemia associated with IT regimens.