NEUROBEHAVIORAL COMPLICATIONS IN TYPE I DIABETIC ADULTS

糖尿病的医学并发症是众所周知的。 大小血管的损伤似乎 与慢性高血糖症有关，因此， 代谢控制不良的糖尿病患者有很大的 发生视网膜病变、肾病、外周血管疾病的风险增加 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，但越来越多的报告表明， 至少一些糖尿病患者表现出显著的 在各种认知测试中的表现 我们自己的工作 表明，虽然最近的代谢水平 控制与神经心理功能没有明显的关系， 糖尿病发病年龄是一个强有力的预测因素， 损伤 当糖尿病患者成年后开始 糖尿病并发症的症状 他们也会表现出 神经行为退化的证据 迄今为止， 没有对I型糖尿病（胰岛素- 依赖性）糖尿病。 尽管一些调查人员 表明代谢控制不良可能与 心理效率的降低，这些研究是基于 对少数受试者的评估相对有限。 没有 目前还没有尝试研究复杂的内部- 糖尿病相关变量和器官之间的关系 变量（例如，年龄;性别）。 拟议的研究将在一个大的， 随机选择接受I型糖尿病治疗的成人样本 1950年至1960年间， 1979. 还将招募非糖尿病对照组。 将使用三种类型的行为测量： 神经心理测验;信息加工任务; 心理社会评估问卷。 此外，详细 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 患者最近接受了完整的身体检查 体检和专门测试 并发症 我们的最终目标是确定 神经行为功能与脑梗死的严重程度 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.