COGNITIVE FUNCTION & HYPOGLYCEMIA IN CHILDREN WITH IDDM

这项研究的目的是确认潜在的有害物质 轻度低血糖对儿童认知功能的影响 胰岛素依赖型糖尿病(IDDM)，从以前的建议 工作。这项研究旨在探索儿童和儿童之间的差异 成人、患有和不患有IDDM的男性和女性。先验的影响 将对血糖控制进行评估。此外，病理生理学 可能与认知变化有关的机制 将对低血糖进行评估。两种变化之间的相关性 低血糖时脑血流和认知功能的改变 被追寻。肾上腺素输注和肾上腺素能受体阻滞剂对大鼠心脏功能的影响 将检查认知功能和脑血流量。这个 研究对象将包括70名患有IDDM的儿童和成人 成人和青少年健康对照组30例。 改善IDDM患者血糖控制的尝试是 与低血糖发作的发生率增加有关。温和的， 通常未被发现的低血糖症可能更常见，即 普遍接受。如果这些插曲，尽管是短暂的，已经 累积影响，这可能会损害学校的功能并最终 学术成就。如果确认有重大的认知变化 一项对儿童的大规模研究，这种潜在的副作用收紧了 血糖控制将不得不在成本效益比中权衡 努力预防IDDM的慢性并发症。识别 更好地了解高危患者的发病机制 认知变化，可能允许发展未来的战略， 可能会避免这种复杂情况，同时仍能实现 糖尿病治疗。

The objective of this study is to confirm the potentially detrimental effects of mild hypoglycemia on cognitive function in children with insulin dependent diabetes (IDDM), which has been suggested from previous work. The study is designed to explore differences between children and adults and males and females with and without IDDM. The effects of prior glycemic control will be assessed. In addition, pathophysiologic mechanisms that may be associated with cognitive changes during hypoglycemia will be evaluated. A correlation between alterations in cerebral blood flow and cognitive changes during hypoglycemia will be sought. The effects of epinephrine infusion and adrenergic blockade on cognitive function and cerebral blood flow will be examined. The population to be studied will consist of 70 children and adults with IDDM and 30 adult and adolescent healthy control subjects. Attempts at improvement of glycemic control in patients with IDDM is associated with an increased incidence of hypoglycemic episodes. Mild, often unrecognized, hypoglycemia is probably far more frequent that is generally accepted. If these episodes, despite being transient, have cumulative effects, this could impair school functioning and ultimate academic achievement. If significant cognitive changes are confirmed on a large scale study of children, this potential side effect of tightened glycemic control will have to be weighed into the cost: benefit ratio of attempts to prevent the chronic complications of IDDM. Recognition of patients at risk and a better understanding of the mechanisms of cognitive changes, may allow the development of future strategies that might avoid this complication while still achieving the overall goals of diabetes therapy.