Cognitive Function in Type 1 Diabetic Adults With Early Exposure to Severe

OBJECTIVE — We assessed adulthood cognition in relation to early exposure to severe hypoglycemia (SH). RESEARCH DESIGN ANDMETHODS — Sixteen years subsequent to a study of cog-nitive function in 28 diabetic children and 28 matched control subjects, we reexamined the same subjects with a 96 % participation rate. Diabetic subjects were classified as with (n 9) or without (n 18) early (10 years of age) SH, which was defined as convulsions or loss of consciousness. RESULTS — Overall, cognitive scores were 0.9 SDs lower in subjects with early SH compared with subjects without early SH (P 0.003). The two diabetic groups particularly differed with respect to problem solving, verbal function, and psychomotor efficiency. Earlier age at first incident of SH was associated with poorer cognition (P for trend 0.001). CONCLUSIONS — The findings suggest that early exposure to SH may have lasting and clinically relevant effects on cognition. Diabetes Care 33:1945–1947, 2010 E arly-onset diabetes is associated withreduced cognition (1), possibly dueto the effects of severe hypoglycemia (SH) on the developing brain (2–5). Al-though moderate (1), this cognitive defi-cit seems to be enduring (5–7). We hypothesized that earlier age at SH occur-rence would entail more pronounced ef-fects on cognition. In this 16-year follow-up study of diabetic subjects, we investigated cognitive function in relation to early exposure to SH