dc.contributor.author | Macharia, Anne-Marie | |
dc.date.accessioned | 2015-12-16T07:29:02Z | |
dc.date.available | 2015-12-16T07:29:02Z | |
dc.date.issued | 2015 | |
dc.identifier.uri | http://hdl.handle.net/11295/93616 | |
dc.description.abstract | Background
Type 1 Diabetes Mellitus (T1DM) is one of the most common chronic diseases
of childhood. The burden of diabetes in children in Kenya is unknown, but the
Ministry of Health estimates that three million people have the condition.
Diabetes is known to cause cognitive dysfunction secondary to both its acute
and chronic complications. Early recognition of this is important to help these
children maintain normal intellectual function and achieve their full potential.
Objectives
To compare the cognitive function in children with Type 1 diabetes with that of
non-diabetic children at Kenyatta National Hospital; and within the population
of diabetic children, determine the relationship between cognitive function and
both the duration of diabetes and level of glycaemic control.
Study design
This was a hospital based cross-sectional comparative study with two arms
recruiting diabetic and non-diabetic children, respectively.
Methods
Sixty-six children with T1DM aged 7 to 16 years were enrolled from the
paediatric Endocrinology clinic. Sixty-seven children aged 7 to 16 years
recruited from the paediatric out-patient clinic formed the comparative group.
The Modified Mini-Mental State Exam (MMSE) was administered to all
children meeting inclusion criteria and scores were categorized into either
normal or impaired cognitive function using age-specific cut-offs.
Results
Median (lower - upper IQR) age of children with diabetes was 13 (10-15) years
and the median age in non-diabetics was 12 (10-13) years. There was no
significant difference in cognitive function assessed using MMSE scores
between diabetic and non-diabetic children. Overall, 17 out of the 66 diabetics
(25.8%) had low MMSE score compared to 14 (20.9%) non-diabetics (OR =
1.31, 95% CI 0.54-3.21). The cognitive function did not differ significantly for
the subdomains of the MMSE with mean scores for diabetics and non-diabetics
of: 11.2 versus 11.3 (orientation); 6.0 versus 5.9 (attention and concentration);
3.0 versus 3.0 (registration); 2.3 versus 2.4 (recall) and 10.3 versus 10.4
(language). However, there was some evidence of higher scores for recall in
non-diabetic children aged 12-14 years compared to diabetic children in the
same age group (p = 0.078).
Conclusion
There was no significant difference in cognitive function in diabetic children
compared to non-diabetic children as assessed using the Modified Mini Mental
Status Examination.
Recommendations
Baseline and serial assessment may be more useful than a single assessment of
the MMSE. A different tool may detect subtle differences in cognition. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.title | Cognitive function in children aged 7 to 16 years with type 1 diabetes at Kenyatta National Hospital | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |