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Journal of Pediatric Psychology Advance Access published online on July 17, 2008

Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn074
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Neuro-cognitive Performance in Children with Type 1 Diabetes—A Meta-analysis

Justine M. Naguib, BSc, MBBS1, Elena Kulinskaya, PhD2, Claire L. Lomax, PhD3 and M. Elena Garralda, MD4

1School of medicine, 2Statistical Advisory Service, Imperial College, 3Department of Psychology, Institute of Psychiatry, Kings College, and 4Academic Unit of Child and Adolescent Psychiatry, Imperial College

All correspondence concerning this article should be addressed to Professor Elena Garralda, MD, Academic Unit of Child and Adolescent Psychiatry, Imperial College, St Mary's Campus, Norfolk Place, London W21PG, UK. E-mail: e.garralda{at}imperial.ac.uk


   Abstract

Objective To conduct meta-analyses of neuropsychological performance in young people with type 1 diabetes. Methods Meta-analysis of 24 studies. Studies published between 1980 and 2005 were identified. The inclusion criteria were: young people who were ≤19 years of age with type 1 diabetes, a case–control design and standardized neuropsychological tests of seven cognitive domains. Results Diabetes was statistically associated with poorer performance on visuospatial ability (d = –0.29), motor speed (d = –0.26) and writing (d = –0.28), on sustained attention (d = –0.21) and reading (d = –0.23). Smaller effects were identified on full IQ (d = –0.14), on performance (d = –0.18) and verbal IQ (d = –0.15). Severe hypoglycemia was linked to deficits in short-term verbal memory (d = –0.14; Confidence Interval: –0.318, 0.024; p =.04). Conclusions This meta-analysis indicates that children with type 1 diabetes have mild cognitive impairments and subtly reduced overall intellectual functioning.

Key words: diabetes; meta-analysis; neuro-cognitive; pediatric.

Received September 3, 2007; revision received June 19, 2008; accepted June 21, 2008


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