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Cognitive disengagement syndrome in children with type 1 diabetes: important implications for clinical outcomes

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Abstract

Aims

Children with type 1 diabetes (T1D) are prone to a variety of psychiatric disorders, however, to date, no study has examined cognitive disengagement syndrome (CDS) in children with T1D. The present study aimed to evaluate the frequency of CDS symptoms in children with T1D and whether it is related to glycemic control.

Methods

This cross-sectional study included 74 children with T1D and 88 healthy (control) children, aged 8–14 years. All children were evaluated through a semi-structured psychiatric interview, the Kent-EGY test, porteus maze test, stroop test TBAG form, Barkley child attention scale, and Conners' parent rating scale-revised-short form.

Result

Children with T1D had considerably higher rates of elevated CDS symptoms than control children (35.1% vs. 10.2%, p < 0.001). Children with T1D performed poorly on attention and cognitive tests. High levels of CDS symptomatology were strongly associated with earlier diabetes onset age, longer disease duration, a higher percentage of diabetic ketoacidosis at diagnosis, higher HbA1c levels, and higher daily insulin dosages. Also, T1D patients with elevated CDS symptoms had lower IQ and attention scores and worse cognitive function performance compared to participants with low levels of CDS symptomatology.

Conclusions

Elevated CDS symptoms are significantly higher in children with T1D and are associated with poorer diabetes control. The routine psychiatric examination of children with T1D should also include a screening for CDS, particularly in patients with poor glycemic control.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgements

We are very grateful to all of our participants and their parents who shared their experiences for so generously taking the time to take part in our research.

Funding

There are no funders to report for this submission.

Author information

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Faculty of Medicine, Sivas Cumhuriyet University, Yenisehir, Kayseri St., No:43, 58140, Sivas, Turkey

    Ayla Uzun Cicek

  2. Division of Pediatric Endocrinology, Department of Child Health and Diseases, Faculty of Medicine, Sivas Cumhuriyet University, 58140, Sivas, Turkey

    Nurullah Celik

Authors
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Contributions

AUC and NC were involved in the conception, design, and conduct of the study and the analysis and interpretation of the results. AUC wrote the first draft of the manuscript, and NC edited and reviewed it. Both authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Ayla Uzun Cicek.

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Conflict of interest

There are no financial, personal, or professional interests related to this article.

Ethical Standard Statement

The study was approved by the institutional ethical review board (approval number: 2022-02/35, date: 16.02.2022). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent Statement

All children and their parents/guardians signed informed assent and consent forms, respectively. The subjects’ identities were omitted to protect their privacy.

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This article belongs to the topical collection Health Education and Psycho-Social Aspects, managed by Massimo Porta and Marina Trento.

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Uzun Cicek, A., Celik, N. Cognitive disengagement syndrome in children with type 1 diabetes: important implications for clinical outcomes. Acta Diabetol 61, 53–61 (2024). https://doi.org/10.1007/s00592-023-02178-w

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