ESPE Abstracts (2015) 84 P-3-696

Influence of hypoglycemic episodes on attention and behavioural abnormalities in diabetic children

Michael Wurm, Vera Niebuhr, Kristiane Hallermann, Alexandra Krause, Natascha van der Werf-Grohmann & Karl Otfried Schwab

Kinderklinik, Universität Freiburg, Freiburg, Germany

Background: Type 1 diabetes may have an influence on concentration, attention and behaviour. These effects are relevant, as they may affect school performance and later career options for paediatric diabetes patients.

Objective and hypotheses: This study examined attention, concentration and behavioural difficulties in diabetic children aged 5–13 years and their association with hypoglycaemic episodes and HbA1c.

Method: 48 children with type 1 diabetes mellitus (age 5–13 years, 28 boys, 20 girls) were stratified for HbA1c over the last 2 years (good diabetes control HbA1c <7.5%; average or bad diabetes control HbA1c >7.5%), number of hypoglycaemia per month (<1 episode/month, 1–5 episodes/month, >5 episodes/month). Parents answered the Strengths and difficulties questionnaire (SDQ, screening for behavioural abnormalities and difficulties). KiTAP, a computer based test, was used to test selectivity, intensity, flexibility and control of impulse in the patients. School grades were assessed. Differences between groups were tested for significance using Mann–Whitney U tests. Correlations were calculated using Spearman’s rank correlation coefficients.

Results: Attention (tested with the KiTAP tool) was significantly better in patients with 1–5 hypoglycaemic episodes compared to patient with >5 episodes. There was no overall statistic difference in patients with <1 compared to >5 hypoglycaemic episodes/month. SD-questionnaire did not show increased behavioural abnormalities or correlation with HbA1c in diabetic children. Attention did not correlate with HbA1c. There was no significant difference for attention between the low HbA1c group and the high HbA1c group.

Conclusion: These results suggest that the frequency of hypoglycaemia exerts an influence on attention. Although literature shows that hypoglycaemia does not cause permanent cognitive impairment, recent hypoglycaemia seems to influence attention. Diabetic children do not have behavioural abnormalities. Good diabetes control with absence of hypoglycaemia should be achieved.

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