P-98: Cognitive impairments in children and adolescents with type 1 diabetes: the role of acute metabolic episodes
P Wais, E Niechciał, K Majewska, P Fichna, A Kędzia, M Stanisławska-KubiakAbstract
Introduction
Type 1 diabetes (T1D) in children and adolescents is associated not only with metabolic dysregulation but also with potential alterations in neurodevelopment. Acute metabolic episodes, particularly clinically significant hypoglycemia (CSH) and diabetic ketoacidosis (DKA), may adversely affect cognitive functions, including attention and executive functioning.
Objectives
To evaluate the impact of acute metabolic episodes on attentional functioning in pediatric patients with T1D.
Methods
A total of 117 children and adolescents with T1D (47.0% female; mean age 12.86 ± 3.16 years; mean diabetes duration 5.64 ± 4.01 years; mean HbA1c 7.49 ± 1.53% were included. Participants were stratified into four groups based on the presence of DKA and/or CSH. Attentional functioning was assessed using the MOXO Continuous Performance Test (MOXO-CPT), evaluating sustained attention, timeliness, impulsivity, and hyperactivity. Associations between acute metabolic episodes and cognitive outcomes were analyzed.
Results
A history of CSH was associated with significantly lower sustained attention scores and slower timeliness (both p < 0.001). Patients with a history of DKA demonstrated significantly higher impulsivity scores compared to those without DKA (p = 0.008). No significant differences were observed in hyperactivity.
Conclusions
Acute metabolic episodes in pediatric T1D are associated with impairments in specific domains of attentional functioning. Prevention and careful monitoring of CSH and DKA may be important for preserving cognitive outcomes in this population.