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Glycemic extremes are related to cognitive dysfunction in children with type 1 diabetes: A meta-analysis.

Glycemic extremes are related to cognitive dysfunction in children with type 1 diabetes: A meta-analysis.
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He J, Ryder AG, Li S, Liu W, Zhu X,


He J, Ryder AG, Li S, Liu W, Zhu X, (click to view)

He J, Ryder AG, Li S, Liu W, Zhu X,

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Journal of diabetes investigation 2018 03 23() doi 10.1111/jdi.12840
Abstract
AIMS
To examine the magnitude and pattern of cognitive dysfunction in children with type 1 diabetes and the possible effects associated with other disease variables, such as early onset diabetes, severe hypoglycemia and hyperglycemia.

MATERIALS AND METHODS
We conducted a meta-analysis using the PRISMA guidelines. We searched MedLine, Embase, and PsycINFO to identify studies on cognitive function in children with type 1 diabetes that were published up until September 30th, 2016. Effect sizes understood as the standardized mean differences between groups with diabetes and control groups (i.e., Hedges’ g), were calculated to quantify the extent of cognitive dysfunction in those groups consisting of children with diabetes.

RESULTS
Nineteen studies met our inclusion criteria, comprising a total of 1,355 participants with type 1 diabetes and 696 controls. Compared with non-diabetic controls, children with type 1 diabetes showed a significantly poorer cognitive performance overall (g = -0.46), as well as specific deficits in full scale intelligence (g = -1.06), attention (g = -0.60), and psychomotor speed (g = -0.46). Glycemic extremes were associated with poorer overall cognition (g=-0.18) as well as slightly lower performance in memory (g = -0.27).

CONCLUSIONS
We found that type 1 diabetes was associated with cognitive dysfunction characterized by a lowered intelligence, a diminished attention and a slowing of psychomotor speed. Glycemic extremes, which described as a period of high glucose levels and severe hypoglycemia, was related to cognitive dysfunction in children with type 1 diabetes. This article is protected by copyright. All rights reserved.

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