Predictors of change in the neuropsychological profiles of children with type 1 diabetes 2 years after disease onset

OBJECTIVE - To identify type 1 diabetes-related predictors of change in the neuropsychological profiles of children over the first 2 years of the illn ess. RESEARCH DESIGN AND METHODS- Children (n = 116) aged 3-14 years were assess ed soon after diagnosis and re-evaluated 2 years later to examine relations hips bctu een illness variables, such as age of onset and metabolic control history, and changes in neuropsychological status over the first 2 years o f type 1 diabetes. RESULTS - Illness variables were significant predictors of change in neurop sychological test scores within 2 years of onset of type 1 diabetes. Age of onset of type 1 diabetes predicted negative change on Performance Intellig ence Quotient, whereas both recurrent severe hypoglycemia and chronic hyper glycemia were associated with reduced memory and learning capacity CONCLUSIONS- These results suggest that the relationship between metabolic control and neuropsychological risk is nonlinear in that children with eith er recurrent severe hypoglycemia or chronically elevated blood sugars exhib it negative changes in their neuropsychological profiles. Onset of type 1 d iabetes very early in life adds another dimension of risk, particularly aff ecting the acquisition of visuospatial skills.