Diabetic ketoacidosis tied to lower IQ in kids with type1 diabetes
https://medicaldialogues.in/diabetes-endocrinology/news/diabetic-ketoacidosis-tied-to-lower-iq-in-kids-with-type1-diabetes-study-69821
Diabetic ketoacidosis (DKA) is a
serious but common complication of type 1 diabetes.It happens when diabetes
goes undiagnosed or is poorly managed. With diabetic ketoacidosis, blood sugar
gets very high as acidic substances called ketones build up to dangerous levels
in the body. Early signs of diabetic ketoacidosis include excessive thirst,
frequent urination, and nausea, abdominal pain, weakness and confusion.
UC Davis Health researchers have found in a new study that diabetic ketoacidosis (DKA) is linked to lower IQ scores and worse memory in children with type 1 diabetes. Children who experienced moderate and severe DKA had lower long-term memory compared to children with diabetes and no exposure to DKA.
Further DKA effects may be exacerbated in children with chronic exposure to hyperglycemia.
It is also
a first large-scale work to differentiate between impact of diabetic ketoacidosis
on children with a new diagnosis and children with a previous diagnosis of type
1 diabetes.
The study has been published in Diabetes Care.
"We assessed the neurocognitive effects
of DKA in children with known type 1diabetes as well as in those who were just
diagnosed with it," said Simona Ghetti, professor of psychology at UC
Davis and the lead author on the study. "Our study uncovered that even one
severe episode of DKA in children newly diagnosed with type 1 diabetes is
linked to cognitive problems; and among children with a previous diagnosis,
repeated DKA exposure predicted lower cognitive performance after accounting
for glycemic control."
The study included 376 children with type 1 diabetes and no DKA history and 758
children with type 1 diabetes and a history of DKA. These children, ages 6-18
years, were participating in a DKA clinical trial at the Pediatric Emergency
Care Applied Research Network (PECARN) sites led by two of the study's
co-authors, Nathan Kuppermann and Nicole Glaser.
One severe DKA episode can hurt memory and IQ
The study
found that among children newly diagnosed with type 1 diabetes, those who
experienced moderate and severe DKA had lower long-term memory compared to
children with diabetes and no exposure to DKA. Greater severity of DKA was also
associated with lower IQ in these children.
Children
with a previous diagnosis showed lower performance compared with children with
new onset in measures of memory and IQ, suggesting that cognitive deficits may
worsen over time.
The study's large sample allowed the researchers to capture complex associations of DKA severity, socioeconomic status and blood sugar control among previously diagnosed patients. These associations revealed that patients with repeated DKA exposure and poorly controlled type 1 diabetes are at substantial risk of cognitive deficits.
"The
results from the study emphasize the importance of prevention of DKA in
children with known type 1 diabetes and of timely diagnosis during new onset
before the development of DKA," said Glaser, professor of pediatrics at UC
Davis Health and senior author of the study. "There is an opportunity to
prevent DKA with proper management of the glucose level in the blood."