A Study on the Cognitive Functions in Adolescents and children with Type-1-Diabetes Mellitus

Background: Type one Diabetes Mellitus-(T1DM) can be accompanied with cognitive impairments due to dysglycemic states including hyperglycemia, hypoglycemic states, and diabetic ketoacidosis (DKA). This study evaluates cognitive functions in children with T1DM and examines the impact of factors associated with diabetes. Methods: This cross-sectional study included 100 children with T1DM (6–14 years) and 100 agematched non-diabetic controls at the National Institute for Diabetes and Endocrinology, Cairo. Cognitive function was assessed using the Arabic Stanford–Binet Intelligence Scale. Glycemic control (HbA1C ≥ 7%) and DKA history were analyzed. Results: Children with T1DM had significantly lower IQ scores (84.15 ± 17.61) than controls (96.87 ± 10.54, p = 0.002), with deficits in abstract reasoning (p = 0.003), quantitative cognition (p = 0.005), and short-term memory (p = 0.002). Poor glycemic control (HbA1C ≥ 8.5%) correlated with cognitive impairment (p < 0.005). Frequent severe hypoglycemia (>5 episodes in 6 months) and early disease onset (years) were associated with lower cognitive performance (p < 0.05). Conclusion: Insufficient control of the hyperglycemic state, frequent hypoglycemia, and early-onset diabetes negatively affect the cognitive function among young people and children with T1DM. Routine neurocognitive assessments, optimized glucose management, and educational support are essential to avoid cognitive decline.