Relation of Serum Insulin Like Growth Factor- 1 With Cognitive Performance in Type 1 Diabetic Children

Abstract

Type 1 diabetes mellitus (T1DM) is the most commonly diagnosed type of DM in children and adolescents. It presents usually with symptomatic hyperglycemia and imparts the immediate need for exogenous insulin replacement.The presentation of T1DM is either as classic new onset (most common)which is characterized with polyuria, polydipsia, polyphagia and lethargy, silentT1DM which typical lydiagnosed by families or physicians with high index of suspicionor DKA which presents with dehydration, vomiting, altered mental status and rapid deep respiration (Kussmaul’sbreathing).T1DMleads to alterations in the growth hormone–insulin-like growth factor -1 (GH–IGF-1) axis.T1DM resulted in impairment of cognitive functions as visual motor development, visual spatial memory, visual organization, visual perception, short term memory, concentration and selective attention. Our aim in this study was to investigate the relation between serum IGF-1 and cognitive performance in children with type 1 diabetes mellitus.

This case control study included 40 children, with type 1 diabetes mellitus recruited from the regular attendants of the Diabetes Clinic, Children's Hospital, Ain Shams University during a full calendar year, they were 18 males and 22 females, their ages ranged from 6 to 10 years. Inclusion criteria: • Cases diagnosed with Type 1 diabetes mellitus. • Prepubescent (not more than Tanner stage 1). Exclusion criteria: • Cases diagnosed with Type 1 diabetes mellitus and associated with another chronic disease that may affect cognitive performance as chronic renal failure, cardiac diseases and genetic disorders. • Cases proved to be mentally retarded. • Cases with auditory impairment. • Cases with visual impairment. They were classified into two groups: Group І:20 patients with type 1 diabetes with HbA1c < 8%(10 males; 10 females) with ages ranging from 6 to 10 years. Group П:20patients with type 1 diabetes with HbA1c ≥