NEUROBEHAVIORAL COMPLICATIONS IN TYPE I DIABETIC ADULTS

糖尿病的医学并发症是众所周知的。 小血管和大血管的损伤似乎是 与慢性高血糖有关，因此， 代谢控制不良的糖尿病患者有很大的 发展为视网膜病、肾病、外周疾病的风险增加 神经病和严重的心血管疾病。一个器官 在糖尿病相关并发症的讨论中通常被忽视 是大脑，然而越来越多的报告表明 至少有一些糖尿病患者表现出显著的 在广泛的认知测试中出现障碍。我们自己的工作 青少年的情况表明，虽然新陈代谢的程度 控制与神经心理功能没有明显的关系， 糖尿病的发病年龄是一个强有力的预测因子。 减损。 当糖尿病患者步入成年期并开始 糖尿病明显的内科并发症？他们会不会也展示 神经行为恶化的证据？到目前为止，有 没有对成人I型(胰岛素-胰岛素)患者进行系统评估 依赖)糖尿病。尽管一些调查人员已经 提示新陈代谢控制不良可能与 精神效率的降低，这些研究的基础是 对少数受试者的评估相对有限。不是 人们还试图研究复杂的内部关系 糖尿病相关变量与机体的关系 变量(例如，年龄、性别)。 这项拟议的研究将对这些关系进行大规模、 随机选择的接受I型糖尿病治疗的成年人样本 匹兹堡儿童医院1950年至2005年间的糖尿病 1979年。还将招募一组非糖尿病对照组。 将使用三种类型的行为衡量标准：正式 神经心理测验；信息处理任务； 心理社会评价问卷。此外，详细介绍了 将获得糖尿病相关变量的生物医学数据 由于所有糖尿病受试者同时参与 糖尿病流行病学研究。因此，每个糖尿病患者 患者最近将接受全面的体检 评估医学的检查和专门测试 并发症。我们的最终目标是确定这一关系 神经行为功能与严重程度和程度之间的关系 微血管和大血管并发症。

The medical complications of diabetes mellitus are well known. Damage to the small and large blood vessels appears to be associated with chronic hyperglycemia, and as a consequence, diabetic individuals in poor metabolic control have a greatly increased risk of developing retinopathy, nephropathy, peripheral neuropathy, and serious cardiosvascular disease. One organ generally ignored in discussions of diabetes-related complications is the brain, yet an increasing number of reports have suggested that at least some diabetic individuals show significant impairments on a wide range of cognitive tests. Our own work with adolescents suggests that while degree of recent metabolic control is not obviously related to neuropsychological functioning, the age at onset of diabetes is a powerful predictor of impairment. What happens as diabetic individuals reach adulthood and begin to manifest medical complications of diabetes? Will they also show evidence of neurobehavioral deterioration? To date, there has been no systematic assessment of adults with Type I (insulin- dependent) diabetes. Although several investigators have suggested that poor metabolic control may be associated with a reduction in mental efficiency, those studies have been based on relatively limited assessments of small numbers of subjects. No attempt has yet been made to examine the complex inter- relationships among diabetes-related variables and organismic variables (e.g., age; gender). The proposed study will examine these relationships in a large, randomly selected sample of adults who were treated for Type I diabetes at Children's Hospital of Pittsburgh between 1950 and 1979. A nondiabetic comparison group will also be recruited. Three types of behavioral measures will be used: formal neuropsychological tests; information-processing tasks; psychosocial assessment questionnaires. In addition, detailed biomedical data on diabetes-related variables will be obtained since all diabetic subjects are concurrently participating in the Epidemiology of Diabetes study. As a consequence, each diabetic patient will have recently received a complete physical examination and specialized tests assessing medical complications. Our ultimate goal is to determine the relationship between neurobehavioral functioning and the severity and extent of micro-and macrovascular complications.