Cognitive impairments in type 1 diabetes mellitus

Abstract

Type 1 diabetes mellitus (DM) is one of the most prevalent endocrinological disorders of childhood. This disorder is accompanied by numerous micro- and macrovascular complications that reduce children’s life expectancy and increase healthcare costs. Central nervous system (CNS) damage in children and adolescents with type 1 DM is a fairly common but poorly studied complication. The leading role among CNS changes is played by cognitive dysfunction (CD). The pathophysiological aspects of CD in type 1 DM haven’t yet been understood completely. The three main triggers are hypoglycemia, chronic moderate hyperglycemia, and acute hyperglycemia (diabetic ketoacidosis). Evidence is presented to show the development of morphological abnormalities of the brain with progression of type 1 DM in children. Damage in the formation of white and gray matter, hippocampus, amygdala, the processes of myelination disorders have been described, which can also be the cause of CD development in this contingent of patients. Peculiarities ofclinical manifestations of CD in children and adolescents with type 1 DM depending on the localization of the brain lesion are described. A more pronounced CD was found in cases when DM debuts in early childhood (up to 5 years). Timely diagnosis and correction of CD in children and adolescents with type 1 DM can improve the therapeutic and prophylactic prognosis in this disease.