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A recent study published in Diabetes Care, an authoritative journal in the field of diabetes, aims to assess whether a single episode of diabetic ketoacidosis (DKA) is associated with cognitive decline in newly diagnosed children with type 1 diabetes, taking into account changes in blood sugar control and other related factors, as well as in children who have been diagnosed in the past.
researchers recruited 758 children between the ages of 6 and 18 who participated in a randomized multisite clinical trial evaluating intravenous infusion programmes to treat DKA.
430 children were moderate/severe DKA and 328 children were mild DKA.
392 DKA children in the study were new cases of type 1 diabetes, with the rest being previously diagnosed with diabetes.
neurocognitive assessment was conducted within 2 to 6 months of the onset of DKA.
also included 376 children with type 1 diabetes who did not have a DKA attack as a control.
In all patients, moderate/severe DKA was associated with a lower IQ (beta-0.12, P-lt;0.001), entry-color recall (beta-0.08, P-0.010), and forward digital span (beta-0.06, P-0.04).
newly diagnosed patients, moderate/severe DKA was associated with lower entry-color recall (beta-0.08, P-0.04).
after adjusting for hypoglycemia, diabetes duration, and socioecuric conditions, patients diagnosed with DKA recurrent seizures and higher HbA1c were associated with lower IQs (beta-0.10 and beta-0.09, P-lt;0.01, respectively), while higher HbA1c was associated with lower project color memory (beta-0.10, P-0.007).
, a single DKA attack was associated with a mild decline in memory after the diagnosis of type 1 diabetes.
significant decline in IQ can be detected in children with pre-diabetes, suggesting that the role of DKA may be exacerbated in children with chronic hyperglycemia.
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