CHANGES IN ATTENTION WITH HYPOGLYCEMIA AND HYPERGLYCEMIA IN CHILDREN WITH INSULIN-DEPENDENT DIABETES-MELLITUS

We compared the results of a computerized attention test (TOVA) in 38 children with insulin dependent diabetes mellitus in relation to vario us spontaneously occurring blood glucose levels. Testing was performed at the following blood glucose levels. <3.3 mmol/l (hypoglycaemia), 3 .3-8.3 mmol/l (normoglycaemia) and >8.3 mmol/l (hyperglycaemia). The a ttention (sum of errors and response time) varied significantly with t he blood glucose level (P = 0.002). The highest number of errors of om ission and the longest response time was observed during the test run with hypoglycaemia. Age, sex, age at manifestation of the disease,meta bolic control and the results of the intelligence test had no signific ant influence on these results. We found that attention in children wi th diabetes was significantly reduced compared to TOVA norms especiall y during mild hypoglycaemia (P < 0.001). Irrespective of the blood glu cose levels, reaction time and the variability of the reaction time di ffered significantly between TOVA norms and diabetic children (P < 0.0 1). Conclusion In children with diabetes mellitus a significant reduct ion in attention was found at mild hypoglcaemia but as well at low nor mal blood glucose levels. Attention deficits due to transient lowering of blood glucose mar therefore occur in diabetic children even before they are aw:are of hypoglycaemic symptoms.