COGNITIVE FUNCTIONS & HYPOGLYCEMIA IN CHILDREN WITH IDDM

本研究的目的是确认潜在的有害 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），这已经从以前的建议， 工作 这项研究旨在探索儿童和 成年人和男性和女性有和没有胰岛素依赖性糖尿病。 先前的影响 将评估血糖控制。 此外，病理生理学 可能与认知变化有关的机制， 将评估低血糖。 基因的改变与 低血糖期间的脑血流量和认知变化将 寻求。 肾上腺素输注和肾上腺素能阻滞对大鼠脑缺血再灌注损伤的影响 将检查认知功能和脑血流量。 的 研究人群将包括70名儿童和成人胰岛素依赖型糖尿病患者 30例健康成人和青少年对照组。 试图改善胰岛素依赖型糖尿病患者的血糖控制， 与低血糖发作的发生率增加有关。 温和， 通常未被识别，低血糖可能更频繁， 普遍接受。 如果这些事件，尽管短暂， 累积效应，这可能会损害学校的运作， 学术成就 如果确认发生了重大认知变化， 一项针对儿童的大规模研究表明， 血糖控制将不得不权衡成本效益比 试图预防胰岛素依赖型糖尿病的慢性并发症。 识别 患者的风险和更好地了解的机制， 认知的变化，可能允许未来战略的发展， 可以避免这种复杂性，同时仍然实现总体目标， 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.