Human and experimental animal data suggest both hyperglycemia and hypoglycemia can lead to altered brain structure and neurocognitive function in type 1 diabetes (T1D). Young children with T1D are prone to extreme fluctuations in glucose levels. The overlap of these potential dysglycemic insults to the brain during the time of most active brain and cognitive development may cause cellular and structural injuries that appear to persist into adult life. Brain structure and cognition in persons with T1D are influenced by age of onset, exposure to glycemic extremes such as severe hypoglycemic episodes, history of diabetic ketoacidosis, persistent hyperglycemia, and glucose variability. Studies using brain imaging techniques have shown brain changes that appear to be influenced by metabolic abnormalities characteristic of diabetes, changes apparent at diagnosis and persistent throughout adulthood. Some evidence suggests that brain injury might also directly contribute to psychological and mental health outcomes. Neurocognitive deficits manifest across multiple cognitive domains. Moreover, impaired executive function and mental health can affect patients’ adherence to treatment. This review summarizes the current data on the impact of glycemic extremes on brain structure and cognitive function in youth with T1D and the use of new diabetes technologies that may reduce these complications.
Horm Res Paediatr

中文翻译：

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低血糖和高血糖对 1 型糖尿病幼儿认知和大脑发育的影响

人类和实验动物数据表明，高血糖和低血糖均可导致 1 型糖尿病 (T1D) 的大脑结构和神经认知功能改变。患有 T1D 的幼儿容易出现葡萄糖水平的极端波动。在最活跃的大脑和认知发育期间，这些潜在的血糖异常损害对大脑的重叠可能会导致似乎持续到成年生活的细胞和结构损伤。T1D 患者的大脑结构和认知受发病年龄、暴露于极端血糖（如严重的低血糖发作）、糖尿病酮症酸中毒史、持续性高血糖和血糖变异性的影响。使用脑成像技术的研究表明，大脑变化似乎受到糖尿病代谢异常特征的影响，诊断时明显的变化并在整个成年期持续存在。一些证据表明，脑损伤也可能直接导致心理和心理健康结果。神经认知缺陷表现在多个认知领域。此外，执行功能和心理健康受损会影响患者对治疗的依从性。这篇综述总结了目前关于极端血糖对 1 型糖尿病患者大脑结构和认知功能的影响的数据，以及可以减少这些并发症的新糖尿病技术的使用。执行功能和心理健康受损会影响患者对治疗的依从性。这篇综述总结了当前关于极端血糖对 1 型糖尿病患者大脑结构和认知功能的影响的数据，以及可以减少这些并发症的新糖尿病技术的使用。执行功能和心理健康受损会影响患者对治疗的依从性。这篇综述总结了目前关于极端血糖对 1 型糖尿病患者大脑结构和认知功能的影响的数据，以及可以减少这些并发症的新糖尿病技术的使用。
儿科荷尔蒙