S. Ghetti, N. Kuppermann, A. Rewers, SR. Myers, JE. Schunk, MJ. Stoner, A. Garro, KS. Quayle, KM. Brown, JL. Trainor, L. Tzimenatos, AD. DePiero, JK. McManemy, LE. Nigrovic, MY. Kwok, CS. Olsen, TC. Casper, NS. Glaser, et al. (2023). Cognitive function following diabetic ketoacidosis in young children with type 1 diabetes. Endocrinology, diabetes & metabolism, 6(3), e412. https://doi.org/10.1002/edm2.412

PubMed 36788736

[Abstract]
INTRODUCTION: Young children with type 1 diabetes (T1D) may be at particularly high risk of cognitive decline following diabetic ketoacidosis (DKA). However, studies of cognitive functioning in T1D typically examine school-age children. The goal of this study was to examine whether a single experience of DKA is associated with lower cognitive functioning in young children. We found that recently diagnosed 3- to 5-year-olds who experienced one DKA episode, regardless of its severity, exhibited lower IQ scores than those with no DKA exposure.

METHODS: We prospectively enrolled 46 3- to 5-year-old children, who presented with DKA at the onset of T1D, in a randomized multi-site clinical trial evaluating intravenous fluid protocols for DKA treatment. DKA was moderate/severe in 22 children and mild in 24 children. Neurocognitive function was assessed once 2-6 months after the DKA episode. A comparison group of 27 children with T1D, but no DKA exposure, was also assessed. Patient groups were matched for age and T1D duration at the time of neurocognitive testing.

RESULTS: Children who experienced DKA, regardless of its severity, exhibited significantly lower IQ scores than children who did not experience DKA, F(2, 70) = 6.26, p = .003, partial η2  = .15. This effect persisted after accounting for socioeconomic status and ethnicity.

CONCLUSIONS: A single DKA episode is associated with lower IQ scores soon after exposure to DKA in young children.