Tip 1 diabetes mellitus tanılı çocuk ve adölesanlarda kognitif fonksiyonlar
Küçük Resim Yok
Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Tip 1 Diabetes Mellitus tanısıyla izlenen 6-18 yaş aralığındaki çocuklarda diyabet başlangıç yaşı, glisemik kontrol, diyabet süresi, çoklu doz insülin tedavisi ve insülin infüzyon pompası kullanımı, DKA atak sayısı gibi birçok faktörün bilişsel işlevler üzerine etkisini araştırmak. Gereç ve Yöntem: Ege Üniversitesi Çocuk Endokrinoloji ve Diyabet Bilim Dalı’nda en az 5 yıldır T1DM tanısıyla izlenen ve 6-18 yaş aralığında olan 48 çocuk çalışmaya dahil edildi. Daha öncesinde saptanmış bir psikiyatrik bozukluk veya T1DM dışında bilinen başka bir kronik rahatsızlığı bulunan çocuklar çalışma dışı bırakıldı. Bilinen bir kronik rahatsızlığı bulunmayan sağlıklı 37 çocuk kontrol grubunu oluşturmuştur. Çalışmamızda T1DM tanılı çocuklar ve kontrol grubundaki sağlıklı çocukların nörokognitif fonksiyonları incelendi. Nörokognitif fonksiyonların değerlendirmesinde Wechsler Çocuklar için Zeka Ölçeği (WISC-R) ile zeka, Görsel İşitsel Sayı Dizileri B Formu (GİSD-B) testi ile kısa süreli bellek, Bender Gestalt Testi ile görsel motor algı ve Moxo Sürekli Dikkat ve Performans testi ile dikkat, zamanlama, hiperaktivite ve dürtüsellik değerlendirildi. Bulgular: Tip 1 Diabetes Mellitus tanılı çocuklar ile kontrol grubu arasında yapılan Wechsler Zeka Ölçeğinin sözel zeka bölümü, performans zeka bölümü ve toplam zeka bölümü puan ortalamaları açısından gruplar arasında istatistiksel olarak anlamlı farklılık saptandı. (p=0,013 p=0,049 p=0,012). Moxo Dikkat ve Performans testi karşılaştırıldığında Moxo testinde Dürtüsellik açısından istatistiksel olarak anlamlı farklılık saptandı. (p=0,04) Diğer yapılan tüm nörokognitif testlerde kontrol grubu ile fark saptanmadı. (p>0,05) Tip 1 DM grubu kendi içinde incelendiğinde, metabolik kontrol derecesine göre orta ve kötü metabolik kontrol grubu arasında yapılan WISC-R puan dağılımında sözel zeka bölümü açısından aralarında istatistiksel olarak anlamlı farklılık saptandı.(p=0,009) Diyabetik ketoasidoz atak geçirme durumuna göre ayrılan iki alt grubun WISC-R puan dağılımları karşılaştrıldığında sözel ve toplam zeka puanı açısından anlamlı farklılık saptandı. (p=0,023 p=0,041) Diyabet tanı yaşı, diyabet süresi, Tip 1 Diabetes Mellitus tedavisinde kullanılan yöntemler, HbA1c değişkenliği ve ortalaması açısından istatistiksel olarak anlamlı farklılık saptanmadı.
INTRODUCTION and AIM: To investigate the effects of many factors such as age of onset, glycemic control, duration of diabetes, conventional insulin therapy and insulin infusion pump use, and number of DKA attacks on cognitive functions in children aged 6-18 years who are followed up with the diagnosis of Type 1 Diabetes Mellitus. MATERIALS and METHOD: Forty-eight children aged 6-18 years, who were followed up with the diagnosis of T1DM for at least 5 years in the Ege University Department of Pediatric Endocrinology and Diabetes, were included in the study. Children with a previously identified psychiatric disorder or other known chronic disease other than T1DM were excluded from the study. 37 healthy children without a known chronic disease formed the control group. In our study, the neurocognitive functions of children with T1DM and healthy children in the control group were examined. In the evaluation of neurocognitive functions, intelligence with Wechsler Children's Intelligence Scale (WISC-R), short-term memory with Audio-Auditory Digits Form B (GISD-B) test, visual motor perception with Bender Gestalt Test and attention with Moxo Continuous Attention and Performance test, timing, hyperactivity, and impulsivity were assessed. RESULTS: A statistically significant difference was found between the groups in terms of the verbal intelligence quotient, performance intelligence quotient and total intelligence quotient mean scores of the Wechsler Intelligence Scale administered between the children with Type 1 Diabetes Mellitus and the control group. (p=0,013 p=0,049 p=0,012). In addition, when Moxo Attention and Performance tests were compared, a statistically significant difference was found in terms of Moxo Impulsivity. (p=0,04) No statistically significant difference was found when all other neurocognitive tests were taken into account. (p>0.05) When the Type 1 DM group was examined within itself, a statistically significant difference was found between them in terms of verbal intelligence in the WISC-R score distribution between the moderate and poor metabolic control groups according to the degree of metabolic control. (p=0.009) When the WISC-R score distributions of the two subgroups separated according to their exacerbation status were compared, a significant difference was found in terms of verbal and total intelligence scores. (p=0,023 p=0,041) No statistically significant difference was found in terms of age at diagnosis of diabetes, duration of diabetes, treatment modality of Type 1 Diabetes Mellitus, HbA1c variability. CONCLUSION: Poor metabolic control and DKA attack in children with type 1 diabetes adversely affect neurocognitive functions. It is thought that it would be beneficial to consider cognitive factors that negatively affect neurocognitive functions in Type 1 Diabetes Mellitus and to take necessary precautions in the follow-up.
INTRODUCTION and AIM: To investigate the effects of many factors such as age of onset, glycemic control, duration of diabetes, conventional insulin therapy and insulin infusion pump use, and number of DKA attacks on cognitive functions in children aged 6-18 years who are followed up with the diagnosis of Type 1 Diabetes Mellitus. MATERIALS and METHOD: Forty-eight children aged 6-18 years, who were followed up with the diagnosis of T1DM for at least 5 years in the Ege University Department of Pediatric Endocrinology and Diabetes, were included in the study. Children with a previously identified psychiatric disorder or other known chronic disease other than T1DM were excluded from the study. 37 healthy children without a known chronic disease formed the control group. In our study, the neurocognitive functions of children with T1DM and healthy children in the control group were examined. In the evaluation of neurocognitive functions, intelligence with Wechsler Children's Intelligence Scale (WISC-R), short-term memory with Audio-Auditory Digits Form B (GISD-B) test, visual motor perception with Bender Gestalt Test and attention with Moxo Continuous Attention and Performance test, timing, hyperactivity, and impulsivity were assessed. RESULTS: A statistically significant difference was found between the groups in terms of the verbal intelligence quotient, performance intelligence quotient and total intelligence quotient mean scores of the Wechsler Intelligence Scale administered between the children with Type 1 Diabetes Mellitus and the control group. (p=0,013 p=0,049 p=0,012). In addition, when Moxo Attention and Performance tests were compared, a statistically significant difference was found in terms of Moxo Impulsivity. (p=0,04) No statistically significant difference was found when all other neurocognitive tests were taken into account. (p>0.05) When the Type 1 DM group was examined within itself, a statistically significant difference was found between them in terms of verbal intelligence in the WISC-R score distribution between the moderate and poor metabolic control groups according to the degree of metabolic control. (p=0.009) When the WISC-R score distributions of the two subgroups separated according to their exacerbation status were compared, a significant difference was found in terms of verbal and total intelligence scores. (p=0,023 p=0,041) No statistically significant difference was found in terms of age at diagnosis of diabetes, duration of diabetes, treatment modality of Type 1 Diabetes Mellitus, HbA1c variability. CONCLUSION: Poor metabolic control and DKA attack in children with type 1 diabetes adversely affect neurocognitive functions. It is thought that it would be beneficial to consider cognitive factors that negatively affect neurocognitive functions in Type 1 Diabetes Mellitus and to take necessary precautions in the follow-up.
Açıklama
Anahtar Kelimeler
Anahtar kelime mevcut olmadığı için bu alan boş bırakılmıştır.
