Researchers from Washington University School of Medicine in St. Louis and the University of Washington in Seattle have found evidence of slight memory impairment in children receiving intensive therapy (IT) for insulin-dependent diabetes.
Reporting in the August 1999 edition of the journal Diabetes Care, the investigators said such children have three times the risk for severe hypoglycemia (low blood glucose) and a slight decline in performance on a test to measure spatial memory function. The research was supported in part by grants from the Juvenile Diabetes Foundation and the U.S. Public Health Service.
Most diabetes experts now recommend IT for patients with diabetes because the nationwide Diabetes Control and Complications Trial (DCCT) showed that intensive therapy could keep patients healthier longer. The DCCT concluded that by keeping blood glucose levels within a narrow window, intensive therapy could delay the onset of the major complications of diabetes: vision loss, nerve problems and kidney failure.
But the DCCT also found that as patients worked to keep glucose levels under tighter control, they increased the risk that those levels would fall too low. Adults and adolescents on IT had an increased risk of severe hypoglycemia, which can cause weakness, confusion and loss of consciousness and, in the worst cases, seizures or coma. This new study found a similar elevated risk in children.
Tracking hypoglycemic events
The Washington University investigators studied 25 children with insulin-dependent diabetes. Of those, 13 were randomly assigned to receive intensive therapy. They were expected to measure their blood glucose at least four times each day and use three to four insulin injections or an insulin pump to control their blood glucose levels.
The other 12 children received the older, conventional diabetes therapy. They checked blood glucose two to four times each day and used one or two insulin injections.