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Clinical utility of mental state screening as a predictor of intellectual outcomes 6 months after diagnosis of type 1 diabetes

Nadebaum, C. , Scratch, S.E , Northam, E.A. , Cameron, F.J., Wellard, R.M, Alexopoulos, J. , Cullen, C. , Ditchfield, M.R. , Finney, K. , Inder, T.E. , Jennings, J.E. , Kean, M. , Knight, S.J. , Koves, I.H. , Lee, K.J. , Lin, A. , Mackay, M.T. , Neil, J.J. , Spencer-Smith, M.M. , & Werther, G.A. (2012) Clinical utility of mental state screening as a predictor of intellectual outcomes 6 months after diagnosis of type 1 diabetes. Pediatric Diabetes, 13(8), pp. 632-637.

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Abstract

Background

Screening tests of basic cognitive status or ‘mental state’ have been shown to predict mortality and functional outcomes in adults. This study examined the relationship between mental state and outcomes in children with type 1 diabetes.

Objective

We aimed to determine whether mental state at diagnosis predicts longer term cognitive function of children with a new diagnosis of type 1 diabetes.

Methods

Mental state of 87 patients presenting with newly diagnosed type 1 diabetes was assessed using the School-Years Screening Test for the Evaluation of Mental Status. Cognitive abilities were assessed 1 wk and 6 months postdiagnosis using standardized tests of attention, memory, and intelligence.

Results

Thirty-seven children (42.5%) had reduced mental state at diagnosis. Children with impaired mental state had poorer attention and memory in the week following diagnosis, and, after controlling for possible confounding factors, significantly lower IQ at 6 months compared to those with unimpaired mental state (p < 0.05).

Conclusions

Cognition is impaired acutely in a significant number of children presenting with newly diagnosed type 1 diabetes. Mental state screening is an effective method of identifying children at risk of ongoing cognitive difficulties in the days and months following diagnosis. Clinicians may consider mental state screening for all newly diagnosed diabetic children to identify those at risk of cognitive sequelae.

Impact and interest:

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1 citations in Web of Science®

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ID Code: 50607
Item Type: Journal Article
Additional Information: The Diabetic Ketoacidosis and Brain Injury Study Group. Alexopoulos, J.1, Cameron, F.J.2,3,4, Cullen, C.3,4, Ditchfield, M.R.3,5,6 , Finney, K.1 , Inder, T.E.1 , Jennings, J.E.2,3, Kean, M.2,3, Knight, S.J.2,3, Koves, Pediatric Diabetes 2012 5 Clinical utility of mental state screening I.H.7 , Lee, K.J.3,4 , Lin, A.3,8 , Mackay, Nadebaum, C.3 , Neil, J.J.1 , Northam, Scratch, S.E.3 , Spencer-Smith, M.M.3 , R.M.9, Werther, G.A.2,3,4 M.T.2,3 , E.A.2,3 , Wellard, 1Department of Pediatrics, Neurology and Radiol- ogy, Washington University, St Louis, USA 2 Department of Endocrinology and Diabetes, Department of Psychology and Children’s Neuro- science Centre, Royal Children’s Hospital, Melbourne, Australia 3Diabetes, Child Neuropsychology, Medical Imag- ing Research, and Clinical Epidemiology and Bio- statistics Unit, Murdoch Childrens Research Institute, Melbourne, Australia 4 Department of Paediatrics and Department of Psychology, University of Melbourne, Melbourne, Australia 5 Department of Medicine, Monash University, Victoria, Australia 6 Monash Children’s Hospital, Southern Health, Victoria, Australia 7Division of Endocrinology and Diabetes, Seattle Children’s Hospital, Seattle, USA 8School of Psychology, University of Birmingham, Edgbaston, UK 9Queensland University of Technology, Brisbane, Australia
Keywords: child, cognition, diabetes mellitus type 1 , ketosis, neuropsychology
DOI: 10.1111/j.1399-5448.2012.00870.x
ISSN: 1399-543X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Clinical Sciences not elsewhere classified (110399)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NEUROSCIENCES (110900) > Neurosciences not elsewhere classified (110999)
Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > PSYCHOLOGY (170100) > Biological Psychology (Neuropsychology Psychopharmacology Physiological Psychology) (170101)
Divisions: Current > Schools > School of Chemistry, Physics & Mechanical Engineering
Current > QUT Faculties and Divisions > Creative Industries Faculty
Current > Institutes > Institute of Health and Biomedical Innovation
Current > QUT Faculties and Divisions > Science & Engineering Faculty
Copyright Owner: Copyright 2012 Blackwell Publishing
Copyright Statement: The definitive version is available at www3.interscience.wiley.com
Deposited On: 25 May 2012 08:41
Last Modified: 27 Nov 2013 14:00

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