Attentional functioning in children and adolescents with IDDM.

OBJECTIVE: To determine whether specific attentional cognitive processes are disrupted in children and adolescents with IDDM. RESEARCH DESIGN AND METHODS: We tested 103 children and adolescents with IDDM and 100 healthy control subjects (age range 9.3-18.3 years) for intelligence and attention. Subjects were given multiple clinical tests of attention and a computerized vigilance test, all of which served to provide information about multiple components of attentional processing. Specific components studied were the abilities to focus, select, shift, suppress, inhibit, and sustain attention. A diabetic history was obtained for the IDDM group, and blood glucose levels were determined before and after computerized attention testing.
RESULTS: Across tests, IDDM subjects differed from control subjects only in the select component of attention, which was accounted for mainly by the poorer performance of children with early-onset diabetes (< 6 years). When subgrouped by history of seizures from hypoglycemia, those having had seizures demonstrated a lower verbal IQ and greater difficulty with select, focus, and inhibit attentional components, whereas sustain, suppress, and shift attentional components were unaffected. Correlation analyses showed that higher concurrent blood glucose levels were associated with less adequate ability to inhibit impulsive responses, whereas multiple regression analyses indicated that inhibit and focus were best predicted by onset age and concurrent blood glucose.
CONCLUSIONS: In children and adolescents with IDDM, attention is poorer in several but not all aspects of attention; these aspects are affected by a history of seizures from hypoglycemia and higher ambient blood glucose levels at time of testing. These results suggest both organizational and activational effects of diabetes on specific subcomponents of attention in diabetes.