CUMULATIVE COGNITIVE IMPAIRMENT FOLLOWING RECURRENT SEVERE HYPOGLYCEMIA IN ADULT PATIENTS WITH INSULIN-TREATED DIABETES-MELLITUS
CUMULATIVE COGNITIVE IMPAIRMENT FOLLOWING RECURRENT SEVERE HYPOGLYCEMIA IN ADULT PATIENTS WITH INSULIN-TREATED DIABETES-MELLITUS
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DOI：
10.1007/bf00405006
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发表时间：
1991-05-01
期刊：
影响因子：
8.2
通讯作者：
FRIER, BM
中科院分区：
文献类型：
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作者：
LANGAN, SJ;DEARY, IJ;FRIER, BM
为了检验严重低血糖发作可能导致累积性认知障碍的假设，对100名1型（胰岛素依赖型）糖尿病患者进行了检查。他们的年龄范围为25-52岁，糖尿病的发病发生在19岁以后。排除有器质性脑疾病（包括脑血管疾病）证据的患者。使用问卷评估胰岛素治疗期间发生的低血糖发作的数量、频率和严重程度，并根据全科实践和医院病例记录验证了该回顾性信息的准确性。进行了详细的神经心理评估，包括患病前和现在的智商（韦氏修订版），记忆和信息处理速度的测试。观察到重度低血糖发生频率与智力下降幅度、操作IQ、检查时间和反应时间之间存在显著相关性（低血糖发生频率越高的患者表现越差）。根据患者的重度低血糖经历确定了两个亚组患者，并在病前智商、年龄和糖尿病病程方面保持平衡。一个亚组（n = 23）从未发生重度低血糖（A组），而另一个亚组（n = 24）至少发生5次重度低血糖（B组）。B组的智力损害程度高于A组，与A组相比，B组的平均反应时也明显较慢，反应时方差也较大。可以得出结论，在接受胰岛素治疗的成人糖尿病患者中，复发性重度低血糖与累积性认知损害相关。
To examine the hypothesis that episodes of severe hypoglycaemia may cause cumulative cognitive impairment, 100 Type 1 (insulin-dependent) diabetic patients were examined. Their age range was 25-52 years, and the onset of diabetes had occurred after the age of 19 years. Patients with evidence of organic brain disease, including cerebrovascular disease, were excluded. A questionnaire was used to assess the number, frequency and severity of hypoglycaemic episodes experienced during treatment with insulin and the accuracy of this retrospective information was verified from general practice and hospital case-notes. A detailed neuro-psychological assessment was undertaken, including tests of pre-morbid and present IQ (Wechsler-Revised), memory and information-processing speed. Significant correlations were observed between the frequency of severe hypoglycaemia and the magnitude of intellectual decline, Performance IQ, inspection time and reaction time (patients with the more frequent hypoglycaemia had poorer performance). Two sub-groups of patients were identified on the basis of their experience of severe hypoglycaemia, and were balanced for pre-morbid IQ, age and duration of diabetes. One sub-group (n = 23) had never experienced severe hypoglycaemia (Group A), whilst the other sub-group (n = 24) had suffered at least five episodes of severe hypoglycaemia (Group B). Group B had greater intellectual impairment than Group A, and Group B also had a significantly slower mean reaction time and higher reaction time variance when compared with Group A. It is concluded that recurrent severe hypoglycaemia is associated with cumulative cognitive impairment in adult diabetic patients treated with insulin.