الفهرس 
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Abstract
Objective: To assess the cognitive functions and academic performance in children and adolescents with type 1 diabetes mellitus (T1DM) and identify the most possible risk factors affecting them.
Methods: This is a cross sectional study of 90 children and adolescents with T1DM attending Pediatric Diabetes Clinic, Children’s Hospital, Ain Shams University were classified into 3 matched groups as follows: newly diagnosed, controlled and uncontrolled T1DM. All the included patients were subjected to detailed medical history with especial emphasis on the most possible risk factors affecting brain functions. An IQ test using Wechsler intelligence scale for children (WISC) was performed for all the 3 groups and overall academic grades were recorded, based on the scores obtained in the main subjects (Arabic, English and Mathematics).
Results: Total number of all patients (n=90); 30 in each group, their mean age was 11.42 ± 3.50 years old with mean age at diagnosis was 7.57 ± 3.42 years old and median duration of T1DM was 4 years with 10% of the patients were admitted to the hospital by DKA. Comparison between the 3 groups of type 1 diabetic patients according to diabetes-related variables revealed that, patients with controlled T1DM were found to be significantly the lowest HA1c level (mean 7.84 ± 1.5) (P-value = 0.000) and the earliest age of diagnosis (mean 5.7 ± 2.95) ( P-value = 0.000) with the longest duration of T1DM (median 5.5 years) (P-value = 0.000), they got the best IQ test grades (P-value = 0.017) and academic grades (P-value = 0.000) in all subjects compared with other groups of uncontrolled and newly diagnosed type 1 diabetic patients. Analysis of the IQ and academic grades in relation to the studied parameters revealed that; high levels of HA1c are associated with cognitive and academic affection rather than the age at diagnosis, duration of the disease and frequency of hypoglycemia in children and adolescents with T1DM.
Conclusion: Metabolic derangements associated with T1DM affect brain integrity in children and adolescents which in turn affect their cognitive and academic functions. The most important risk factors are late diagnosis, chronic hyperglycaemia and DKA occurrence.