Clinically significant cognitive impairment is present in more than a quarter of middle-aged adults who had been diagnosed with type 1 diabetes in childhood, according to a new study.
The results were published online July 7, 2015 in Diabetes Care by Karen A Nunley, PhD, a postdoctoral associate in epidemiology at the University of Pittsburgh, Pennsylvania, and colleagues.
Wide neuropsychiatric testing among 97 adults with an average age of 49 years who had been diagnosed with type 1 diabetes in childhood revealed a prevalence of 28% of clinically significant cognitive impairment, which is comparable to the prevalence of mild cognitive impairment typically reported in adults aged 85 years and older.
The finding raises several concerns, Dr. Nunley told Medscape Medical News.
"We are studying adults who were diagnosed mainly in children, whereas previous studies included individuals diagnosed in adulthood, people who were not exposed to metabolic dysregulation associated with diabetes during critical periods of brain development that occurs during the childhood. "
And, he said, the issues are also middle aged adults "who are at risk of changes" normal "age-related cognitive, the effects of which may be amplified by long-term exposure to diabetes."
One explanation could be that chronic hyperglycemia has negative effects on the cerebral vasculature, similar to that known to occur in the retina or the kidney, he said.
And one of the main concerns is that cognitive impairment can affect a patient's ability to manage their own diabetes. The Poor executive function could hinder time management, the ability to plan and organize, remember details, and to change the approach, Dr. Nunley said, also adding that impaired psychomotor speed may affect the patient's ability to respond quickly to a dangerous situation - for example, while driving.
However, she also stressed that "we are in no way implying that those with onset type 1 diabetes in children can not become successful adults with significant careers. What we hope to do is raise awareness that cognitive impairment It is a possible complication of diabetes, along the lines of retinopathy and neuropathy, so medical providers can help people with type 1 diabetes and their caregivers understand why this happens. "
The results were published online July 7, 2015 in Diabetes Care by Karen A Nunley, PhD, a postdoctoral associate in epidemiology at the University of Pittsburgh, Pennsylvania, and colleagues.
Wide neuropsychiatric testing among 97 adults with an average age of 49 years who had been diagnosed with type 1 diabetes in childhood revealed a prevalence of 28% of clinically significant cognitive impairment, which is comparable to the prevalence of mild cognitive impairment typically reported in adults aged 85 years and older.
The finding raises several concerns, Dr. Nunley told Medscape Medical News.
"We are studying adults who were diagnosed mainly in children, whereas previous studies included individuals diagnosed in adulthood, people who were not exposed to metabolic dysregulation associated with diabetes during critical periods of brain development that occurs during the childhood. "
And, he said, the issues are also middle aged adults "who are at risk of changes" normal "age-related cognitive, the effects of which may be amplified by long-term exposure to diabetes."
One explanation could be that chronic hyperglycemia has negative effects on the cerebral vasculature, similar to that known to occur in the retina or the kidney, he said.
And one of the main concerns is that cognitive impairment can affect a patient's ability to manage their own diabetes. The Poor executive function could hinder time management, the ability to plan and organize, remember details, and to change the approach, Dr. Nunley said, also adding that impaired psychomotor speed may affect the patient's ability to respond quickly to a dangerous situation - for example, while driving.
However, she also stressed that "we are in no way implying that those with onset type 1 diabetes in children can not become successful adults with significant careers. What we hope to do is raise awareness that cognitive impairment It is a possible complication of diabetes, along the lines of retinopathy and neuropathy, so medical providers can help people with type 1 diabetes and their caregivers understand why this happens. "
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