Diabetes and the Developing Mind: Intelligence Quotient (IQ) and Its Associations in Indian Children and Youth With Type 1 Diabetes

Background Children's verbal intelligence quotient (IQ) may be affected by type 1 diabetes (T1D), potentially leading to a decrease in IQ. Studies have reported associations between IQ and both the age at onset of T1D and glycemic control. However, there are very few studies on children and youth with T1D from India. Early diagnosis of cognitive impairment would allow for timely intervention. Therefore, we aimed to study IQ and its predictors in children and youth with T1D. Methods In this clinic-based cohort study, sociodemographic/educational, anthropometric, lifestyle, and glycemic control details were recorded. The IQ of 413 participants (aged 4-22 years) was assessed using the standardized Binet Kamat Test. Adjusted IQ (AIQ) was computed using age-appropriate formulae. Associations between AIQ and its determinants/predictors were examined using correlation analysis, followed by linear regression analysis, adjusting for possible confounders. Results Study participants (median age: 14.0 years (IQR: 11.0-17.2)) demonstrated average cognitive performance based on standardized AIQ categories, with a median AIQ of 102 (IQR: 91-117). Higher AIQ scores were associated with younger age (standardized β = -0.207) and higher maternal (β = 0.153) and paternal education (β = 0.100). Conversely, poorer glycemic control (glycosylated hemoglobin (HbA1c); β = -0.133) and longer duration of diabetes (β = -0.154) were associated with lower AIQ. In multiple regression analysis, age, duration of diabetes, glycemic control, and maternal education emerged as independent determinants of AIQ in children, adolescents, and youth with T1D. Conclusions Participants with T1D had an average IQ. Glycemic control, age, duration of diabetes, and parental education were important predictors of IQ. Our findings highlight the need for screening for cognitive impairment and emphasize the importance of good glycemic control to optimize IQ in individuals with T1D.