New research has found that diabetic ketoacidosis (DKA), a common complication of type 1 diabetes (T1D), is linked to lower IQ scores and worse memory in children.

The study, published in Diabetes Care, was the first large-scale research to differentiate between DKA’s impact on children with a new diagnosis of T1D and children with a previous diagnosis of the disease. DKA occurs when diabetes goes undiagnosed or is poorly managed, as ketones build up to dangerous levels in the body and the patient’s blood sugar gets very high. Early signs include excessive thirst, frequent urination, nausea, abdominal pain, weakness, and confusion.

The study evaluated 376 children with T1D and no DKA history, as well as 758 children with T1D and a history of DKA. The children were between ages 6 and 18 and who were participating in a DKA clinical trial at the Pediatric Emergency Care Applied Research Network sites.

Investigators found that among children with newly diagnosed T1D, those who experienced moderate and severe DKA had lower long-term memory compared with children with diabetes and no exposure to DKA. Greater severity of DKA was also associated with a lower IQ.

Furthermore, children with a previous diagnosis showed lower performances compared with newly diagnosed children in measurements of memory and IQ, suggesting that the deficits may worsen over time.

The study’s large sample size allowed the investigators to analyze complex associations between DKA severity, socioeconomic status, and glycemic control among patients with previous diagnoses. They found that pediatric patients with repeated DKA exposure and poorly controlled T1D are at substantial risk of cognitive deficits.

“The results from the study emphasize the importance of prevention of DKA in children with known T1D and of timely diagnosis during new onset before the development of DKA,” said co-author Nicole Glaser, MD, in a statement. “There is an opportunity to prevent DKA with proper management of the glucose level in the blood.”

REFERENCE
Complications from diabetes linked to worse memory, IQ in children [news release]. UC Davis; September 22, 2020. https://health.ucdavis.edu/health-news/contenthub/complications-from-diabetes-linked-to-worse-memory-iq-in-children/2020/09. Accessed September 24, 2020.