Browsing by Subject "Tyypin 1 diabetes"

Diabetes mellitus, a disease of glucose metabolism, can have adverse effects on cognition. At worst, these effects may complicate the management of the disease. Type1 diabetes mellitus (T1DM) is caused by an autoimmune mechanism. Dozens of studies have investigated its effects on cognition, and some of the results have been pooled in several meta-analyses. However, the studies are heterogeneous, which complicates evaluating and comparing them, leading to conflicting results in the meta-analyses. This review examines the cognitive effects in different age groups. In children, T1DM has been found to have mild adverse effects on most of the principal cognitive functions, excluding learning and memory. These two can, however, be affected by early-onset T1DM. An early onset is also associated with other adverse cognitive effects. Furthermore, hypoglycaemic episodes caused by treatment may also have deleterious effects, although the results are conflicting. Also in adults, the cognitive effects of T1DM have been found to be mild. However, clinically relevant effects have been reported, particularly in late middle age. Moreover, the effects appear to progress with time. As in children, T1DM in adults is associated with adverse effects in most areas of cognition, excluding learning and memory. An early onset is associated with adverse effects also in adults, although only in conjunction with diabetes complications. Similarly, poor glycaemic control is associated with adverse cognitive effects, though possibly only in conjunction with complications. In the aged, the cognitive effects of T1DM have been studied very little. However, it appears to be associated with an increased risk for dementia. A similar association in type 2 diabetes mellitus has been extensively documented. Moreover, results from an animal study support the notion of T1DM as a risk for Alzheimer’s disease. In conclusion, T1DM appears to cause a subtle decline in many cognitive areas: the effects are small in children and moderate in adults. In the aged, T1DM increases the risk of dementia.