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Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute
Asian Institute of Research, Journal Publication, Journal Academics, Education Journal, Asian Institute

Journal of Health and Medical Sciences

ISSN 2622-7258

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open access

Published: 09 December 2023

Relationship Between Children's Cognitive Function and Type 1 Diabetes Mellitus (T1DM): A Systematic Review

Arohid Allatib, Dian Andriani Ratna Dewi, Shabrina Lathifatunnissa Rais, Muhammad Rakan Kabbani,
Chiquita Jasmine, Kharissa Rahma Rindani, Taufik Hidayat, Andi Nadila Faatin, Farrasila Nadhira, Ni Made Wiliantari

The Republic of Indonesia Defense University, Indonesia Army Central Hospital Gatot Soebroto, Ratna Dewi Principal Clinic

journal of social and political sciences
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Pages: 166-176

Keywords: Type 1 Diabetes Mellitus (T1DM), Cognitive Function, Children


Background: Type 1 diabetes mellitus (T1DM) is the most common type of diabetes in children and is caused by various factors, including immune system abnormalities, genetic factors, and environmental influences. T1DM usually occurs in early to mid-childhood when an autoimmune process damages the pancreas's beta cells, producing insufficient insulin. Purpose: Review several studies on T1DM associated with cognitive decline in children. Methods: The study systematically reviews five articles from randomized controlled trials, focusing on the cognitive function of children with T1DM. It specifically explored the relationship between T1DM, cognitive deficits, and the impact of diabetic ketoacidosis on cognitive function in children. Results: This review included five articles from randomized controlled trials between 1999 and 2023, distributed across two nations. The studies included 1.579 children with T1DM or with Ketoacidosis diabetic. Sample testing with cognitive function measurements in each article. Discussion: Type 1 diabetes patients had milder to moderate cognitive deficits on a variety of neuropsychological tests compared with nondiabetic control subjects. These cognitive deficits are primarily related to mental processing speed, executive function, and memory. Summary: Children with T1DM, especially those with a history of diabetic ketoacidosis, exhibited mild to moderate cognitive deficits, particularly in mental processing speed, executive function, and memory. The review emphasized the potential impact of T1DM on children's cognitive development and academic performance, underscoring the need for early diagnosis and appropriate management to mitigate cognitive decline.


  1. Akil, A. A.-S., Yassin, E., Al-Maraghi, A., Aliyev, E., Al-Malki, K., & Fakhro, K. A. (2021). Diagnosis and treatment of type 1 diabetes at the dawn of the personalized medicine era. Journal of Translational Medicine, 19(1), 137.

  2. Banday, M. Z., Sameer, A. S., & Nissar, S. (2020). Pathophysiology of diabetes: An overview. Avicenna Journal of Medicine, 10(04), 174–188.

  3. Brain Basics: Know Your Brain | National Institute of Neurological Disorders and Stroke. (n.d.). Retrieved November 16, 2023, from

  4. Broadley, M. M., White, M. J., & Andrew, B. (2017). A Systematic Review and Meta-analysis of Executive Function Performance in Type 1 Diabetes Mellitus. Psychosomatic Medicine, 79(6), 684–696.

  5. CDC. (2022). The Effects of Diabetes on the Brain. Central For Disease Control and Prevention.

  6. Chaytor, N. S. (2016). Cognition in adults and older adults with type 1 diabetes: Chicken or egg? Diabetes Spectrum, 29(4), 219–224.

  7. (2019). How Many People Have Diabetes - Diabetes Prevalence Numbers. Diabetes. Co.Uk.

  8. Feinkohl, I., Price, J. F., Strachan, M. W. J., & Frier, B. M. (2015). The impact of diabetes on cognitive decline: potential vascular, metabolic, and psychosocial risk factors. Alzheimer’s Research & Therapy, 7(1), 46.

  9. Ferguson, S. C., Blane, A., Wardlaw, J., Frier, B. M., Perros, P., McCrimmon, R. J., & Deary, I. J. (2005). Influence of an early-onset age of type 1 diabetes on cerebral structure and cognitive function. Diabetes Care, 28(6), 1431–1437.

  10. Ghetti, S., Kuppermann, N., Rewers, A., Myers, S. R., Schunk, J. E., Stoner, M. J., Garro, A., Quayle, K. S., Brown, K. M., Trainor, J. L., Tzimenatos, L., DePiero, A. D., McManemy, J. K., Nigrovic, L. E., Kwok, M. Y., Olsen, C. S., Casper, T. C., & Glaser, N. S. (2023). Cognitive function following diabetic ketoacidosis in young children with type 1 diabetes. Endocrinology, Diabetes & Metabolism, 6(3).

  11. Ghetti, S., Kuppermann, N., Rewers, A., Myers, S. R., Schunk, J. E., Stoner, M. J., Garro, A., Quayle, K. S., Brown, K. M., Trainor, J. L., Tzimenatos, L., DePiero, A. D., McManemy, J. K., Nigrovic, L. E., Kwok, M. Y., Perry, C. S., Olsen, C. S., Casper, T. C., & Glaser, N. S. (2020). Cognitive Function Following Diabetic Ketoacidosis in Children With New-Onset or Previously Diagnosed Type 1 Diabetes. Diabetes Care, 43(11), 2768–2775.

  12. Hadgu, F. B., Sibhat, G. G., & Gebretsadik, L. G. (2019). <p>Diabetic ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes in Tigray, Ethiopia: retrospective observational study</p>. Pediatric Health, Medicine and Therapeutics, Volume 10, 49–55.

  13. Handryastuti, S., Pusponegoro, H. D., Nurdadi, S., Chandra, A., Pramita, F. A., Soebadi, A., Widjaja, I. R., & Rafli, A. (2022). Comparison of Cognitive Function in Children with Stunting and Children with Undernutrition with Normal Stature. Journal of Nutrition and Metabolism, 2022.

  14. Hanifah, I., Oviyanti, F., & Muhtarom. (2022). Child cognitive development is based on maternal education. Aṭfālunā Journal of Islamic Early Childhood Education, 5(1), 15–24.

  15. Hershey, T., Bhargava, N., Sadler, M., White, N. H., & Craft, S. (1999). Conventional versus intensive diabetes therapy in children with type 1 diabetes: effects on memory and motor speed. Diabetes Care, 22(8), 1318–1324.

  16. Jaser, S. S., & Jordan, L. C. (2021). Brain Health in Children with Type 1 Diabetes: Risk and Protective Factors. Current Diabetes Reports, 21(4).

  17. Kahanovitz, L., Sluss, P. M., & Russell, S. J. (2017a). Type 1 Diabetes—A Clinical Perspective. Point of Care: The Journal of Near-Patient Testing & Technology, 16(1), 37–40.

  18. Kahanovitz, L., Sluss, P. M., & Russell, S. J. (2017b). Type 1 Diabetes - A Clinical Perspective. Point of Care, 16(1), 37–40.

  19. Kostopoulou, E., Sinopidis, X., Fouzas, S., Gkentzi, D., Dassios, T., Roupakias, S., & Dimitriou, G. (2023). Diabetic Ketoacidosis in Children and Adolescents; Diagnostic and Therapeutic Pitfalls. Diagnostics, 13(15).

  20. Lacy, M. E., Gilsanz, P., Eng, C. W., Beeri, M. S., Karter, A. J., & Whitmer, R. A. (2020). Recurrent diabetic ketoacidosis and cognitive function among older adults with type 1 diabetes: findings from the Study of Longevity in Diabetes. BMJ Open Diabetes Research & Care, 8(1), e001173.

  21. Lin, A., Northam, E. A., Werther, G. A., & Cameron, F. J. (2015). Risk Factors for Decline in IQ in Youth With Type 1 Diabetes Over the 12 Years From Diagnosis/Illness Onset. Diabetes Care, 38(2), 236–242.

  22. Mauras, N., Buckingham, B., White, N. H., Tsalikian, E., Weinzimer, S. A., Jo, B., Cato, A., Fox, L. A., Aye, T., Arbelaez, A. M., Hershey, T., Tansey, M., Tamborlane, W., Foland-Ross, L. C., Shen, H., Englert, K., Mazaika, P., Marzelli, M., & Reiss, A. L. (2021). Impact of Type 1 Diabetes in the Developing Brain in Children: A Longitudinal Study. Diabetes Care, 44(4), 983–992.

  23. Moheet, A., Mangia, S., & Seaquist, E. R. (2015). Impact of diabetes on cognitive function and brain structure. Annals of the New York Academy of Sciences, 1353(1), 60–71.

  24. Musen, G., In, K. L., Sparks, C. R., Weinger, K., Hwang, J., Ryan, C. M., Jimerson, D. C., Hennen, J., Renshaw, P. F., & Jacobson, A. M. (2006). Effects of type 1 diabetes on gray matter density as measured by voxel-based morphometry. Diabetes, 55(2), 326–333.

  25. Ozougwu, O. (2013). The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus. Journal of Physiology and Pathophysiology, 4(4), 46–57.

  26. Pasi, R., & Ravi, K. (2022). Type 1 diabetes mellitus in pediatric age group: A rising endemic. Journal of Family Medicine and Primary Care, 11(1), 27.

  27. Pourabbasi, A., Tehrani-Doost, M., Ebrahimi Qavam, S., & Larijani, B. (2016). Evaluation of the correlation between type 1 diabetes and cognitive function in children and adolescents, and comparison of this correlation with structural changes in the central nervous system: a study protocol. BMJ Open, 6(4), e007917.

  28. Pulungan, A. B., Fadiana, G., & Annisa, D. (2021). Type 1 diabetes mellitus in children: experience in Indonesia. Clinical Pediatric Endocrinology : Case Reports and Clinical Investigations : Official Journal of the Japanese Society for Pediatric Endocrinology, 30(1), 11–18.

  29. Raghupathy, P. (2015). Diabetic ketoacidosis in children and adolescents. Indian Journal of Endocrinology and Metabolism, 19(7), 55.

  30. Saraswathi, S., Al-Khawaga, S., Elkum, N., & Hussain, K. (2019). A Systematic Review of Childhood Diabetes Research in the Middle East Region. Frontiers in Endocrinology, 10.

  31. Shalimova, A., Graff, B., Gąsecki, D., Wolf, J., Sabisz, A., Szurowska, E., Jodzio, K., & Narkiewicz, K. (2019). Cognitive Dysfunction in Type 1 Diabetes Mellitus. The Journal of Clinical Endocrinology & Metabolism, 104(6), 2239–2249.

  32. Speight, J., & Pouwer, F. (2023). Type 1 Diabetes. Cambridge Handbook of Psychology, Health and Medicine: Third Edition, 477–480.

  33. Tonoli, C. (2013). Diabetes Associated Cognitive Decline: Is There a Role for Exercise? Journal of Diabetes & Metabolism, 01(S10).

  34. Ward, Z. J., Yeh, J. M., Reddy, C. L., Gomber, A., Ross, C., Rittiphairoj, T., Manne-Goehler, J., Abdalla, A. T., Abdullah, M. A., Ahmed, A., Ankotche, A., Azad, K., Bahendeka, S., Baldé, N., Jain, S. M., Kalobu, J. C., Karekezi, C., Kol, H., Prasannakumar, K. M., … Atun, R. (2022). Estimating the total incidence of type 1 diabetes in children and adolescents aged 0–19 years from 1990 to 2050: a global simulation-based analysis. The Lancet Diabetes & Endocrinology, 10(12), 848–858.

  35. Wessels, A. M., Simsek, S., Remijnse, P. L., Veltman, D. J., Biessels, G. J., Barkhof, F., Scheltens, P., Snoek, F. J., Heine, R. J., & Rombouts, S. A. R. B. (2006). Voxel-based morphometry demonstrates reduced grey matter density on brain MRI in patients with diabetic retinopathy. Diabetologia, 49(10), 2474–2480.

  36. Wolfsdorf, J., Glaser, N., & Sperling, M. A. (2006). Diabetic Ketoacidosis in Infants, Children, and Adolescents. Diabetes Care, 29(5), 1150–1159.

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