Effects of Intensive Diabetes Therapy on Neuropsychological Function in Adults in the Diabetes Control and Complications Trial
- 15 February 1996
- journal article
- research article
- Published by American College of Physicians in Annals of Internal Medicine
- Vol. 124 (4) , 379-388
- https://doi.org/10.7326/0003-4819-124-4-199602150-00001
Abstract
Objective: To examine the effect of intensive therapy on neuropsychological performance in patients who participated in the Diabetes Control and Complications Trial (DCCT). Design: Multicenter, randomized, controlled clinical trial. Setting: 29 DCCT clinical centers. Patients: 1441 patients with insulin-dependent diabetes mellitus (IDDM) between 13 and 39 years of age who had had IDDM for 1 to 15 years and had no or minimal retinopathy or nephropathy at baseline. Volunteers were ex eluded if they had a history of substance abuse, psychological disturbance, or recurrent hypoglycemia with coma or seizure. Intervention: Intensive therapy with 3 or more daily insulin injections or continuous subcutaneous insulin infusion, guided by 4 or more glucose tests per day, compared with conventional therapy with 1 or 2 daily insulin injections. Outcome Measures: Neuropsychological assessments were done at baseline; years 2, 5, and 7; and the end of the study. Eight cognitive domain scores were developed from the test results and were used to identify patients whose neuropsychological performance had clinically worsened. Results: Intensive therapy did not affect neuropsychological performance. In addition, patients who had repeated episodes of hypoglycemia did not perform differently than patients who did not have repeated episodes. Conclusion: Intensive therapy and the attendant risk for hypoglycemia were not associated with neuropsychological impairment in the DCCT.Keywords
This publication has 7 references indexed in Scilit:
- Adverse Events and Their Association With Treatment Regimens in the Diabetes Control and Complications TrialDiabetes Care, 1995
- The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes MellitusNew England Journal of Medicine, 1993
- Permanent neuropsychological impairment after recurrent episodes of severe hypoglycaemia in manDiabetologia, 1990
- Specific Intellectual Deficits in Children with Early Onset Diabetes MellitusChild Development, 1988
- The distribution of hypoglycemic brain damageActa Neuropathologica, 1984
- Effects of severe hypoglycemia on the human brain neuropathological case reportsActa Neurologica Scandinavica, 1980
- Differential behavioral effects in frontal lobe diseaseNeuropsychologia, 1968