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Previous episodes of hypoglycemic coma are not associated with permanent cognitive brain dysfunction in IDDM patients on intensive insulin treatment
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Previous episodes of hypoglycemic coma are not associated with permanent cognitive brain dysfunction in IDDM patients on intensive insulin treatment
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Journal Article
Previous episodes of hypoglycemic coma are not associated with permanent cognitive brain dysfunction in IDDM patients on intensive insulin treatment
1998
Overview
Previous episodes of hypoglycemic coma are not associated with permanent cognitive brain dysfunction in IDDM patients on intensive
insulin treatment.
L Kramer ,
P Fasching ,
C Madl ,
B Schneider ,
P Damjancic ,
W Waldhäusl ,
K Irsigler and
G Grimm
Department of Medicine, University of Vienna, Austria. ludwig.kramer@akh-wien.ac.at
Abstract
Intensive insulin treatment of IDDM is associated with increased frequency of hypoglycemic coma. The extent of possible cerebral
sequelae after recovery is still unknown. We studied the impact of previous hypoglycemic coma on neurophysiological measures
of cognitive brain function in 108 patients with adult-onset IDDM receiving intensive insulin treatment. In the study, 55
IDDM patients (age 38 +/- 14 years, mean +/- SD) who had a history of > or =1 (median 3, range 1-35) comatose hypoglycemic
event were compared with 53 IDDM patients (age 34 +/- 12 years) with no history of hypoglycemic events using P300 event-related
potentials and psychometric tests (the Mini-Mental State Exam and trailmaking test, part A). Findings on these patients were
compared with those from 108 matched healthy control subjects. No difference was observed in P300 latencies and psychometric
tests between patients with and without a history of hypoglycemic coma (P300 latency, 346 vs. 342 ms; trailmaking test, 31
vs. 30 s; Mini-Mental State Exam, 29.5 vs. 29.6; NS). In diabetic patients, however, P300 latencies were delayed compared
with those of healthy control subjects (344 vs. 332 ms; P < 0.001) and were correlated to diabetes duration but not to total
hypoglycemic episodes. Scores on the Mini-Mental State Exam (29.5 vs. 29.6; P = 0.59) and trailmaking test (31 vs. 28 s; P
= 0.10) were not different between patients and control subjects. In conclusion, previous episodes of hypoglycemic coma are
not associated with permanent impairment of cognitive brain function in patients with adult-onset IDDM receiving intensive
insulin treatment compared with patients without such episodes. Cognitive brain function, however, is subclinically impaired
in relation to duration of diabetes.
Publisher
American Diabetes Association
Subject
/ Biological and medical sciences
/ Cognition Disorders - chemically induced
/ Cognition Disorders - physiopathology
/ Data Interpretation, Statistical
/ Diabetes Mellitus, Type 1 - blood
/ Diabetes Mellitus, Type 1 - drug therapy
/ Diabetic Neuropathies - blood
/ Diabetic Retinopathy - blood
/ Endocrine pancreas. Apud cells (diseases)
/ Evoked Potentials - drug effects
/ Evoked Potentials - physiology
/ Female
/ Glycated Hemoglobin A - metabolism
/ Humans
/ Hypoglycemia - physiopathology
/ Hypoglycemic Agents - adverse effects
/ Hypoglycemic Agents - therapeutic use
/ Insulin Coma - physiopathology
/ Male
