Journal of the International Neuropsychological Society

Research Articles

Cognitive Functioning in Young Children with Type 1 Diabetes

M. Allison Catoa1, Nelly Maurasa2, Jodie Ambrosinoa3, Aiden Bonduranta4, Amy L. Conrada5, Craig Kollmana6, Peiyao Chenga6, Roy W. Becka6, Katrina J. Ruedya6 c1, Tandy Ayea7, Allan L. Reissa8, Neil H. Whitea9 and Tamara Hersheya10 for the Diabetes Research in Children Network (DirecNet)


a1 Divsions of Neurology, Nemours Children's Clinic, Jacksonville, Florida

a2 Division of Endocrinology, Nemours Children's Clinic, Jacksonville, Florida

a3 Yale Children's Diabetes Program, Yale University, New Haven, Connecticut

a4 Department of Psychiatry, Washington University, St. Louis, Missouri

a5 Division of Pediatric Psychology, University of Iowa Children's Hospital, Iowa City, Iowa

a6 Jaeb Center for Health Research, Tampa, Florida

a7 Department of Pediatric Endocrinology, Stanford University, Stanford, California

a8 Department of Radiology, Pediatrics, Psychiatry and Behavioral Sciences, Stanford University, Stanford, California

a9 Department of Pediatrics and Medicine, Washington University, St. Louis, Missouri

a10 Departments of Psychiatry, Neurology and Radiology, Washington University, St. Louis, Missouri


The aim of this study was to assess cognitive functioning in children with type 1 diabetes (T1D) and examine whether glycemic history influences cognitive function. Neuropsychological evaluation of 216 children (healthy controls, n = 72; T1D, n = 144) ages 4–10 years across five DirecNet sites. Cognitive domains included IQ, Executive Functions, Learning and Memory, and Processing Speed. Behavioral, mood, parental IQ data, and T1D glycemic history since diagnosis were collected. The cohorts did not differ in age, gender or parent IQ. Median T1D duration was 2.5 years and average onset age was 4 years. After covarying age, gender, and parental IQ, the IQ and the Executive Functions domain scores trended lower (both p = .02, not statistically significant adjusting for multiple comparisons) with T1D relative to controls. Children with T1D were rated by parents as having more depressive and somatic symptoms (p < .001). Learning and memory (p = .46) and processing speed (p = .25) were similar. Trends in the data supported that the degree of hyperglycemia was associated with Executive Functions, and to a lesser extent, Child IQ and Learning and Memory. Differences in cognition are subtle in young children with T1D within 2 years of onset. Longitudinal evaluations will help determine whether these findings change or become more pronounced with time. (JINS, 2014, 20, 238–247)

(Received August 16 2013)

(Revised December 09 2013)

(Accepted December 09 2013)


  • Cognition;
  • Early onset;
  • T1DM;
  • Hyperglycemia;
  • Hypoglycemia;
  • Children


c1 Correspondence and reprint requests to: Katrina J. Ruedy, Jaeb Center for Health Research, 15310 Amberly Drive Suite 350, Tampa, FL 33647. E-mail:


*  A full listing of the members of the study group is included in the acknowledgements.