Disease and demographic risk factors for disrupted cognitive functioning in children with insulin-dependent diabetes mellitus (IDDM)

Insulin-Dependent Diabetes Mellitus (IDDM) is an illness that affects the c entral nervous system (CNS). Both acute and chronic metabolic abnormalities relate to poorer neuropsychological functioning in the areas of informatio n processing speed, visual spatial ability, and memory. Children with IDDM demonstrate lower intellectual functioning than controls with some subgroup s at greater risk than others. Poorer metabolic control including both recu rrent hypoglycemia and severe hyperglycemia, earlier age of disease onset, and longer disease duration are related to lower IQ scores. Lower academic achievement scores also are found, and a substantial proportion of children with diabetes have received special school services, especially those chil dren from the higher risk groups. Neurodevelopmentally boys rather than gir ls are at greater risk for learning problems, and gender effects are magnif ied with diabetes. Poorer metabolic control is consistently associated with lower SES groups, and boys from lower SES families have clinically lower I Q scores.