Correlates of neurocognitive abilities in adolescents with insulin-dependent diabetes mellitus (IDDM)

The Insulin Dependent Diabetes Mellitus (IDDM) disease process is characterized by the human body's inability to convert glucose into energy due to a depletion of insulin. Current IDDM treatment regiments fail to precisely replicate the body's natural glucose regulation mechanism and, perhaps as a result, researchers have reported neurophysiological and cognitive disruptions in subjects with IDDM. Modern diabetes management requires the patient to intensively manage numerous skills and behaviors so understanding neurocognitive abilities and the relationship between neurocognitive abilities and self-care skills may help researchers and clinicians to target interventions more effectively to improve life expectancy and quality. However, there is little research that directly links IDDM to the neurocognitive pattern of strengths and weaknesses or neurocognitive abilities with specific self-care behaviors in adolescents with IDDM. We hypothesized that memory and attention were related to specific dietary and injection behaviors; that, across the neurocognitive domains assessed, no significant between-group differences between our present sample and the established norms were present; and that some significant within-group differences were present. Johnson's 24-Hour Recall Interview and a comprehensive battery of neuropsychological tests were administered to 29 adolescents with IDDM to test these hypotheses. Memory and attention did not correlate to specific diet and injection self-care variables, perhaps due to the composition of our sample profile, methodology of data collection and statistical rigor. Our sample mostly performed commensurate with the norms with notable exceptions in complex visual memory, visual attention and complex visual-spatial skills and demonstrated significant within-group differences across attention, complex visual memory and complex visual-spatial skills. Interestingly, we found within these neurocognitive domains a pattern highlighted by a wide range in abilities from significant weakness to significant strength within the memory, attention and visual-spatial neurocognitive domains that strongly suggested a weakness in our present sample's complex visual information processing abilities.