Diagnosis of Cognitive Dysfunction in Children with Type 1 Diabetes Mellitus (Review)

Abstract

Type 1 diabetes mellitus (DM) is a common childhood endocrinopathy that can present with cognitive dysfunction (CD). PubMed, Cochrane Library, eLIBRARY.RU and Medscape databases were searched for Englishand Russian-language articles published from 2010 to 2023 using the following keywords: type 1 diabetes mellitus, children, cognitive dysfunction and diagnosis. Publications on CD in adult patients with type 1 DM were excluded from this review. In children with DM, the aetiology of CD is multifactorial and has the following confirmed risk factors: acute hypoglycaemia, chronic hyperglycaemia, early DM onset and pronounced diabetic ketoacidosis. CD manifests clinically with declined memory, attention, IQ scores, psychomotor reactions and cognitive flexibility. In children with an early disease onset (before the age of 6), CD manifestations are more pronounced. The neuropsychological methods considered part of the gold standard for CD diagnosis in children are: the Stroop Colour and Word Test, Benton Visual Retention Test, Wechsler Intelligence Scale for Children, and Wisconsin Card Sorting Test. The representative instrumental methods include magnetic resonance imaging, electroencephalography, diffusion tensor imaging, etc. They allow us to assess the anatomical and functional changes in the brain of children with type 1 DM. Laboratory-based methods can detect an increase in neurospecific proteins and inflammation markers, which indicates cerebral damage in patients with the disease. Further research is necessary on type 1 DM-associated CD in paediatric practice in order to improve the diagnostic criteria for this complication and its prevention methods.

Keywords

• children with type 1 diabetes mellitus
• cognitive dysfunction
• diagnosis of brain disorders
• neurospecific proteins
• neuropsychological testing
• neuroimaging