COGNITIVE DISORDERS ANALYSIS IN CHILDREN WITH DIABETES MELLITUS TYPE I DEPENDING ON THE STAGE OF THE DISEASE
Aim. The aim of the study was to estimation of possible cognitive deficits in adolescents with type I diabetes mellitus at different stages of the disease. Material and methods. The study involved 52 adolescents (14-18 years old) with a diagnosis of type I diabetes mellitus, confirmed by both clinical and laboratory tests, and the presence of central nervous system damage (from impaired consciousness to sopor), marked hyperglycemia and ketoacidosis. The control group consisted of 26 adolescents admitted for scheduled surgical treatment (conditionally healthy children). Study protocol: cognitive function was assessed using the «Montreal Cognitive Scale»: at stage 1 - when the state of diabetes mellitus was stabilized, after initial admission to the hospital (restoration of consciousness to a clear level), and at stage 2 - two months later, at rehospitalization for routine follow-up in adolescents. The control group of adolescents was tested upon admission to the hospital for scheduled treatment. The obtained data were processed using Statistica 10 software. Differences between the groups were considered significant at p <0,05. Results and discussion. Cognitive dysfunction in patients with diabetes mellitus was detected in both acute and delayed periods. Maximum manifestations of brain dysfunction in children with type I diabetes mellitus were observed exactly in the acute period upon stabilization of diabetes mellitus (restoration of consciousness level to clear, transfer from the intensive care unit to the endocrinology department). Cognitive dysfunction also persisted in children two months after discharge, at the stage of rehabilitation, although its severity was lower. The association between the severity of cognitive impairment, the duration of the disease, and the number of hospitalizations in the intensive care unit during the entire period of illness was revealed only for the acute period of the disease. Conclusion. The presented results confirm the hypothesis that the chronic course of type I diabetes in pediatric practice on the background of frequent exacerbations, manifested by ketoacidosis and hyperglycemia, leads to brain cell damage, which is manifested by brain dysfunction in the form of cognitive impairment throughout the course of the disease. In addition, it was found that the severity of cognitive impairment in adolescents with diabetes mellitus has a relationship with the number of hospitalizations to the intensive care unit and the duration of the disease (that is, with each subsequent hospitalization brain dysfunction increases), which can be explained by the gradual decompensation of neuroplasticity of the central nervous system.