Behaviour Problems in Children With Diabetes as a Function of Sex and Age of Onset of Disease

Rovet, Joanne; Ehrlich, Robert; Hoppe, M. K.

doi:10.1111/j.1469-7610.1987.tb01768.x

Cited by 48 publications

(36 citation statements)

References 42 publications

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“…Several studies have raised concerns about the effects of diabetes on memory and learning in children [2,16,17,18]. Additionally, memory impairment has been observed in older adults with diabetes [19] and in diabetics with hypertension [20].…”

Section: Discussionmentioning

confidence: 99%

Effects of insulin on long-term potentiation in hippocampal slices from diabetic rats

et al. 2003

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Aims/Hypothesis. Cognitive deficits occur commonly in diabetic patients. It is unclear whether these impairments result from hypoglycaemia during intensive insulin therapy, or from the diabetes itself. The aim of this study was to examine if impaired energy utilization resulting from insulin deficiency contributes to impaired long-term potentiation (reflecting impaired synaptic plasticity). As long-term potentiation is considered a candidate cellular mechanism underlying learning and memory, understanding how diabetes alters long-term potentiation may provide insight into mechanisms producing cognitive deficits in diabetes. Methods. Electrophysiologic recordings were used to study long-term potentiation in the CA1 region of hippocampal slices from healthy rats and rats with streptozotocin-induced diabetes.Results. Long-term potentiation was difficult to induce in slices from diabetic rats in standard recording buffer (contains 10 mmol/l glucose). In slices from diabetic rats, increasing extracellular glucose failed to recover long-term potentiation induction, but 10 mmol/l pyruvate added to standard buffer enabled long-term potentiation induction. Moreover, incubation of slices from diabetic rats with insulin enabled long-term potentiation induction in standard buffer. Acute administration of streptozotocin alone did not impair long-term potentiation in slices from healthy animals, and changing extracellular glucose concentrations over the range of 5 mmol/l to 30 mmol/l did not alter long-term potentiation in slices from control rats. Conclusions/interpretation. These observations suggest that impaired energy utilization from insulin deficiency, rather than the accompanying hyperglycaemia, impair long-term potentiation in diabetes. Impaired hippocampal synaptic plasticity could contribute to learning and cognitive impairment in diabetic patients. [Diabetologia (2003) Poor academic performance in diabetic children and memory impairment in adults with diabetes are viewed as increasing public health concerns. These problems are typically thought to result from hypoglycaemic attacks [1,2], which occur more frequently during intensive insulin therapy [3]. Although insulininduced hypoglycaemia could contribute to learning problems [4], one recent prospective study did not find a relationship between severe hypoglycaemic events and cognitive impairment [5], raising the possibility that the diabetic condition alone might adversely affect learning and memory. Experimental evidence supporting an independent effect of diabetes upon

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Section: Discussionmentioning

confidence: 99%

Effects of insulin on long-term potentiation in hippocampal slices from diabetic rats

et al. 2003

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“…Many of these behaviors can also interfere with diabetes selfmanagement. Females are more likely to participate in diabetes mismanagement, whereas boys are more likely to engage in risky behaviors (227,233,234). Alcohol use is a particular problem, as it can be associated with severe hypoglycemia several hours after drinking, if adequate food is not ingested.…”

Section: Recommendationmentioning

confidence: 99%

Care of Children and Adolescents With Type 1 Diabetes

Klingensmith²,

et al. 2005

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“…For example, Littlefield et al (9) found that adolescent girls not only exhibited poorer overall treatment compliance and metabolic control than boys, but that girls with poorer adherence also reported lower self-esteem, less self-efficacy, and more depressive symptoms. However, other studies (8,10,17) using similar methodologies have failed to demonstrate significant links between metabolic control and aspects of the self. In part, these inconsistent findings may result from the failure to consider the moderating role of gender on self-identity formation during adolescence.…”

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confidence: 99%

“…Compared with boys, girls have been shown to exhibit a constant increase in mean HbA 1c , with an estimated increase from pre-to postpuberty of 0.92% (6). Also, girls tend to be more distressed by diabetes (8), to exhibit higher rates of overall mismanagement of their diabetes (9) with less adherence to their diabetes meal plan during periods of stress (10), and to experience greater depressive and eating disorder symptoms, both of which are linked to poor metabolic control (9,11). Thus, there is a need to identify specific risk factors for poor metabolic control in girls.…”

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confidence: 99%

Metabolic Control in Adolescent Girls

et al. 2004

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1OBJECTIVE -This study investigated whether intimacy and autonomy in mother-daughter interactions and relational aspects of the self are associated with metabolic control in adolescent girls with type 1 diabetes. RESEARCH DESIGN AND METHODS-This cross-sectional study included 88 girls with diabetes (mean age 14.9 Ϯ 2.2 years, diabetes duration 7.1 Ϯ 3.9 years, and HbA 1c 8.9 Ϯ 1.6%) from the Diabetes Clinic at the Hospital for Sick Children in Toronto and their mothers. Teens completed a self-report measure assessing self-concept in eight domain-specific areas. Mothers and daughters engaged in a 7-min, videotaped, problem-solving task involving a diabetes-related conflict issue. Interactions were rated using a macroanalytic rating system to assess intimacy and autonomy in parent-teen relationships. Metabolic control was measured using HbA 1c .RESULTS -Self-concept in domains of perceived behavioral conduct (P ϭ 0.003), social acceptance (P ϭ 0.03), romantic appeal (P ϭ 0.03), and close friendships (P ϭ 0.04) independently predicted HbA 1c levels, together accounting for 30% of the variance. Also, the experience of emotional closeness (i.e., intimacy) rather than separateness (i.e., autonomy) in motherdaughter relationships was associated with lower HbA 1c (P ϭ 0.03).CONCLUSIONS -Relational aspects of the self and the experience of emotional closeness in relationships are associated with metabolic control in adolescent girls. Efforts to improve metabolic control in girls should include enhancing the self-concept and the experience of relatedness in familial, peer, and patient-caregiver relationships. Diabetes Care 27:709 -715, 2004

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Behaviour Problems in Children With Diabetes as a Function of Sex and Age of Onset of Disease

Cited by 48 publications

References 42 publications

Effects of insulin on long-term potentiation in hippocampal slices from diabetic rats

Effects of insulin on long-term potentiation in hippocampal slices from diabetic rats

Care of Children and Adolescents With Type 1 Diabetes

Metabolic Control in Adolescent Girls

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