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Cognitive Functioning in Young Children with Type 1 Diabetes

Published online by Cambridge University Press:  11 February 2014

M. Allison Cato
Divsions of Neurology, Nemours Children's Clinic, Jacksonville, Florida
Nelly Mauras
Division of Endocrinology, Nemours Children's Clinic, Jacksonville, Florida
Jodie Ambrosino
Yale Children's Diabetes Program, Yale University, New Haven, Connecticut
Aiden Bondurant
Department of Psychiatry, Washington University, St. Louis, Missouri
Amy L. Conrad
Division of Pediatric Psychology, University of Iowa Children's Hospital, Iowa City, Iowa
Craig Kollman
Jaeb Center for Health Research, Tampa, Florida
Peiyao Cheng
Jaeb Center for Health Research, Tampa, Florida
Roy W. Beck
Jaeb Center for Health Research, Tampa, Florida
Katrina J. Ruedy*
Jaeb Center for Health Research, Tampa, Florida
Tandy Aye
Department of Pediatric Endocrinology, Stanford University, Stanford, California
Allan L. Reiss
Department of Radiology, Pediatrics, Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
Neil H. White
Department of Pediatrics and Medicine, Washington University, St. Louis, Missouri
Tamara Hershey
Departments of Psychiatry, Neurology and Radiology, Washington University, St. Louis, Missouri
Correspondence and reprint requests to: Katrina J. Ruedy, Jaeb Center for Health Research, 15310 Amberly Drive Suite 350, Tampa, FL 33647. E-mail:


The aim of this study was to assess cognitive functioning in children with type 1 diabetes (T1D) and examine whether glycemic history influences cognitive function. Neuropsychological evaluation of 216 children (healthy controls, n = 72; T1D, n = 144) ages 4–10 years across five DirecNet sites. Cognitive domains included IQ, Executive Functions, Learning and Memory, and Processing Speed. Behavioral, mood, parental IQ data, and T1D glycemic history since diagnosis were collected. The cohorts did not differ in age, gender or parent IQ. Median T1D duration was 2.5 years and average onset age was 4 years. After covarying age, gender, and parental IQ, the IQ and the Executive Functions domain scores trended lower (both p = .02, not statistically significant adjusting for multiple comparisons) with T1D relative to controls. Children with T1D were rated by parents as having more depressive and somatic symptoms (p < .001). Learning and memory (p = .46) and processing speed (p = .25) were similar. Trends in the data supported that the degree of hyperglycemia was associated with Executive Functions, and to a lesser extent, Child IQ and Learning and Memory. Differences in cognition are subtle in young children with T1D within 2 years of onset. Longitudinal evaluations will help determine whether these findings change or become more pronounced with time. (JINS, 2014, 20, 238–247)

Research Articles
Copyright © The International Neuropsychological Society 2014 

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A full listing of the members of the study group is included in the acknowledgements.


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