Longitudinal Evaluation of Cognitive Functioning in Young Children with Type 1 Diabetes over 18 Months

M. Allison Cato; Nelly Mauras; Paul Mazaika; Craig Kollman; Peiyao Cheng; Tandy Aye; Jodie Ambrosino; Roy W. Beck; Katrina J. Ruedy; Allan L. Reiss; Michael Tansey; Neil H. White; Tamara Hershey; E. Tsalikian; J. Coffey; J. Cabbage; S. Salamati; A. Conrad; L. A. Fox; K. Englert; K. Sikes; T. Ewen; B. A. Buckingham; D. M. Wilson; T. Aye; K. Caswell; K. Schleifer; C. Ambler; S. A. Weinzimer; W. V. Tamborlane; A. Steffen; K. Weyman; M. Zgorski; J. Ambrosino; A. M. Arbelaez; L. Levandoski; A. Starnes; R. W. Beck; J. Ruedy; C. Kollman; P. Cheng; B. Stevens; N. Njeru; R. Chapman; T. J. Mouse; N. Barnea-Goraly; M. J. Marzelli; D. X. Peng; E. Bihun; A. Al-Lozi; A. Bischoff; M. Cuneo; A. Bondurant; M. Sperling; D. M. Becker; P. Cleary; C. Greenbaum; A. Moran

doi:10.1017/S1355617715001289

Longitudinal Evaluation of Cognitive Functioning in Young Children with Type 1 Diabetes over 18 Months

M. Allison Cato, Nelly Mauras, Paul Mazaika, Craig Kollman, Peiyao Cheng, Tandy Aye, Jodie Ambrosino, Roy W. Beck, Katrina J. Ruedy, Allan L. Reiss, Michael Tansey, Neil H. White, Tamara Hershey, E. Tsalikian, J. Coffey, J. Cabbage, S. Salamati, A. Conrad, L. A. Fox, K. EnglertK. Sikes, T. Ewen, B. A. Buckingham, D. M. Wilson, T. Aye, K. Caswell, K. Schleifer, C. Ambler, S. A. Weinzimer, W. V. Tamborlane, A. Steffen, K. Weyman, M. Zgorski, J. Ambrosino, A. M. Arbelaez, L. Levandoski, A. Starnes, R. W. Beck, J. Ruedy, C. Kollman, P. Cheng, B. Stevens, N. Njeru, R. Chapman, T. J. Mouse, N. Barnea-Goraly, M. J. Marzelli, D. X. Peng, E. Bihun, A. Al-Lozi, A. Bischoff, M. Cuneo, A. Bondurant, M. Sperling, D. M. Becker, P. Cleary, C. Greenbaum, A. Moran

Pediatric Endocrinology

Research output: Contribution to journal › Article › peer-review

36 Scopus citations

Abstract

Objectives: Decrements in cognitive function may already be evident in young children with type 1 diabetes (T1D). Here we report prospectively acquired cognitive results over 18 months in a large cohort of young children with and without T1D. Methods: A total of 144 children with T1D (mean HbA1c: 7.9%) and 70 age-matched healthy controls (mean age both groups 8.5 years; median diabetes duration 3.9 years; mean age of onset 4.1 years) underwent neuropsychological testing at baseline and after 18-months of follow-up. We hypothesized that group differences observed at baseline would be more pronounced after 18 months, particularly in those T1D patients with greatest exposure to glycemic extremes. Results: Cognitive domain scores did not differ between groups at the 18 month testing session and did not change differently between groups over the follow-up period. However, within the T1D group, a history of diabetic ketoacidosis (DKA) was correlated with lower Verbal IQ and greater hyperglycemia exposure (HbA1c area under the curve) was inversely correlated to executive functions test performance. In addition, those with a history of both types of exposure performed most poorly on measures of executive function. Conclusions: The subtle cognitive differences between T1D children and nondiabetic controls observed at baseline were not observed 18 months later. Within the T1D group, as at baseline, relationships between cognition (Verbal IQ and executive functions) and glycemic variables (chronic hyperglycemia and DKA history) were evident. Continued longitudinal study of this T1D cohort and their carefully matched healthy comparison group is planned.

Original language	English (US)
Pages (from-to)	293-302
Number of pages	10
Journal	Journal of the International Neuropsychological Society
Volume	22
Issue number	3
DOIs	https://doi.org/10.1017/S1355617715001289
State	Published - Jan 28 2016

Bibliographical note

Funding Information:
The authors thank the children and their families as well as the clinical and imaging staff at all of the investigator sites. We also thank our external collaborators for use of their imaging facilities, including University of California at San Francisco, El Camino Hospital, and University of Florida & Shands Jacksonville. We are also grateful to Karen Winer, MD, and Ellen Leschek, MD, at NIDDK for advice and support. This research was supported by funding from the NIH (DIRECNET R01 HD078463 U01 HD41890, HD41906-10, HD41908-10, HD41915, HD41918, HD56526) and UL1 RR024992. A. Cato, N. Mauras, P. Mazaika, C. Kollman, P. Cheng, T. Aye, J. Ambrosino, R. Beck, K. Ruedy, A. Reiss, M. Tansey, and T. Hershey report no conflict of interest. N.H. White reports receiving payment for consultancy from Novo Nordisk and Daiichi Sankyo and payments to his institution from Bristol-Myers Squibb for a research grant. The DirecNet Study Group: Clinical Centers: (Personnel are listed as (PI) for Principal Investigator, (I) for co-Investigator, (C) for Coordinators, and (PM) for Psychometrician.) Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA: Eva Tsalikian, MD (PI); Michael J. Tansey,MD(I); Julie Coffey, MSN (C); Joanne Cabbage (C); Sara Salamati (C); Amy Conrad, PhD (PM); Nemours Children’s Health System, Jacksonville, FL: Nelly Mauras, MD (PI); Larry A. Fox, MD (I); Allison Cato, PhD (I); Kim Englert, RN, BSN, CDE (C); Kaitlin Sikes, ARNP, MSN (C); Tina Ewen (C); Division of Pediatrics Endocrinology and Diabetes, Stanford University, Stanford, CA: Bruce A. Buckingham, MD(PI); Darrell M. Wilson, MD (I); Tandy Aye, MD (I); Kimberly Caswell, ARNP (C); Kristin Schleifer (PM); Christian Ambler (PM); Department of Pediatrics, Yale University School of Medicine, New Haven, CT: Stuart A. Weinzimer, MD (PI); William V. Tamborlane, MD (I); Amy Steffen, BS (C); Kate Weyman, MSN (C); Melinda Zgorski, BSN (C); Jodie Ambrosino, PhD (I); Washington University in St. Louis, St. Louis,MO: Neil H. White, MD, CDE (PI); Ana Maria Arbelaez, MD, (I); Lucy Levandoski, PA-C (C); Angie Starnes, RN, BSN, CDE (C), Tamara Hershey, PhD (I). Coordinating Center: Jaeb Center for Health Research, Tampa, FL: Roy W. Beck, MD, PhD; Katrina J. Ruedy, MSPH; Craig Kollman, PhD; Peiyao Cheng, MPH; Beth Stevens; Nelly Njeru; Ryan Chapman, TJ Mouse. Image Coordinating Center: Allan L. Reiss, MD; Naama Barnea- Goraly, MD; Matthew J. Marzelli, BS; Paul M. Mazaika, PhD; Daniel X. Peng, BS. Cognitive Core: Tamara Hershey, PhD; Allison Cato, PhD; Emily Bihun, MA; Amal Al-Lozi, BA; Allison Bischoff, BA; Michaela Cuneo, BA; Aiden Bondurant, BA. Data and Safety Monitoring Board: Mark Sperling, MD; Dorothy M. Becker, MBBCh; Patricia Cleary, MS; Carla Greenbaum, MD; Antoinette Moran, MD.

Publisher Copyright:
© Copyright The International Neuropsychological Society 2016.

Keywords

Children
Cognition
Early onset
Hyperglycemia
Longitudinal
T1D

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1017/S1355617715001289

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Cato, M. A., Mauras, N., Mazaika, P., Kollman, C., Cheng, P., Aye, T., Ambrosino, J., Beck, R. W., Ruedy, K. J., Reiss, A. L., Tansey, M., White, N. H., Hershey, T., Tsalikian, E., Coffey, J., Cabbage, J., Salamati, S., Conrad, A., Fox, L. A., ... Moran, A. (2016). Longitudinal Evaluation of Cognitive Functioning in Young Children with Type 1 Diabetes over 18 Months. Journal of the International Neuropsychological Society, 22(3), 293-302. https://doi.org/10.1017/S1355617715001289

Cato, MA, Mauras, N, Mazaika, P, Kollman, C, Cheng, P, Aye, T, Ambrosino, J, Beck, RW, Ruedy, KJ, Reiss, AL, Tansey, M, White, NH, Hershey, T, Tsalikian, E, Coffey, J, Cabbage, J, Salamati, S, Conrad, A, Fox, LA, Englert, K, Sikes, K, Ewen, T, Buckingham, BA, Wilson, DM, Aye, T, Caswell, K, Schleifer, K, Ambler, C, Weinzimer, SA, Tamborlane, WV, Steffen, A, Weyman, K, Zgorski, M, Ambrosino, J, Arbelaez, AM, Levandoski, L, Starnes, A, Beck, RW, Ruedy, J, Kollman, C, Cheng, P, Stevens, B, Njeru, N, Chapman, R, Mouse, TJ, Barnea-Goraly, N, Marzelli, MJ, Peng, DX, Bihun, E, Al-Lozi, A, Bischoff, A, Cuneo, M, Bondurant, A, Sperling, M, Becker, DM, Cleary, P, Greenbaum, C & Moran, A 2016, 'Longitudinal Evaluation of Cognitive Functioning in Young Children with Type 1 Diabetes over 18 Months', Journal of the International Neuropsychological Society, vol. 22, no. 3, pp. 293-302. https://doi.org/10.1017/S1355617715001289

@article{28d825796430454dbe2aa3d78747eca0,

title = "Longitudinal Evaluation of Cognitive Functioning in Young Children with Type 1 Diabetes over 18 Months",

abstract = "Objectives: Decrements in cognitive function may already be evident in young children with type 1 diabetes (T1D). Here we report prospectively acquired cognitive results over 18 months in a large cohort of young children with and without T1D. Methods: A total of 144 children with T1D (mean HbA1c: 7.9%) and 70 age-matched healthy controls (mean age both groups 8.5 years; median diabetes duration 3.9 years; mean age of onset 4.1 years) underwent neuropsychological testing at baseline and after 18-months of follow-up. We hypothesized that group differences observed at baseline would be more pronounced after 18 months, particularly in those T1D patients with greatest exposure to glycemic extremes. Results: Cognitive domain scores did not differ between groups at the 18 month testing session and did not change differently between groups over the follow-up period. However, within the T1D group, a history of diabetic ketoacidosis (DKA) was correlated with lower Verbal IQ and greater hyperglycemia exposure (HbA1c area under the curve) was inversely correlated to executive functions test performance. In addition, those with a history of both types of exposure performed most poorly on measures of executive function. Conclusions: The subtle cognitive differences between T1D children and nondiabetic controls observed at baseline were not observed 18 months later. Within the T1D group, as at baseline, relationships between cognition (Verbal IQ and executive functions) and glycemic variables (chronic hyperglycemia and DKA history) were evident. Continued longitudinal study of this T1D cohort and their carefully matched healthy comparison group is planned.",

keywords = "Children, Cognition, Early onset, Hyperglycemia, Longitudinal, T1D",

author = "Cato, {M. Allison} and Nelly Mauras and Paul Mazaika and Craig Kollman and Peiyao Cheng and Tandy Aye and Jodie Ambrosino and Beck, {Roy W.} and Ruedy, {Katrina J.} and Reiss, {Allan L.} and Michael Tansey and White, {Neil H.} and Tamara Hershey and E. Tsalikian and J. Coffey and J. Cabbage and S. Salamati and A. Conrad and Fox, {L. A.} and K. Englert and K. Sikes and T. Ewen and Buckingham, {B. A.} and Wilson, {D. M.} and T. Aye and K. Caswell and K. Schleifer and C. Ambler and Weinzimer, {S. A.} and Tamborlane, {W. V.} and A. Steffen and K. Weyman and M. Zgorski and J. Ambrosino and Arbelaez, {A. M.} and L. Levandoski and A. Starnes and Beck, {R. W.} and J. Ruedy and C. Kollman and P. Cheng and B. Stevens and N. Njeru and R. Chapman and Mouse, {T. J.} and N. Barnea-Goraly and Marzelli, {M. J.} and Peng, {D. X.} and E. Bihun and A. Al-Lozi and A. Bischoff and M. Cuneo and A. Bondurant and M. Sperling and Becker, {D. M.} and P. Cleary and C. Greenbaum and A. Moran",

note = "Funding Information: The authors thank the children and their families as well as the clinical and imaging staff at all of the investigator sites. We also thank our external collaborators for use of their imaging facilities, including University of California at San Francisco, El Camino Hospital, and University of Florida & Shands Jacksonville. We are also grateful to Karen Winer, MD, and Ellen Leschek, MD, at NIDDK for advice and support. This research was supported by funding from the NIH (DIRECNET R01 HD078463 U01 HD41890, HD41906-10, HD41908-10, HD41915, HD41918, HD56526) and UL1 RR024992. A. Cato, N. Mauras, P. Mazaika, C. Kollman, P. Cheng, T. Aye, J. Ambrosino, R. Beck, K. Ruedy, A. Reiss, M. Tansey, and T. Hershey report no conflict of interest. N.H. White reports receiving payment for consultancy from Novo Nordisk and Daiichi Sankyo and payments to his institution from Bristol-Myers Squibb for a research grant. The DirecNet Study Group: Clinical Centers: (Personnel are listed as (PI) for Principal Investigator, (I) for co-Investigator, (C) for Coordinators, and (PM) for Psychometrician.) Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA: Eva Tsalikian, MD (PI); Michael J. Tansey,MD(I); Julie Coffey, MSN (C); Joanne Cabbage (C); Sara Salamati (C); Amy Conrad, PhD (PM); Nemours Children{\textquoteright}s Health System, Jacksonville, FL: Nelly Mauras, MD (PI); Larry A. Fox, MD (I); Allison Cato, PhD (I); Kim Englert, RN, BSN, CDE (C); Kaitlin Sikes, ARNP, MSN (C); Tina Ewen (C); Division of Pediatrics Endocrinology and Diabetes, Stanford University, Stanford, CA: Bruce A. Buckingham, MD(PI); Darrell M. Wilson, MD (I); Tandy Aye, MD (I); Kimberly Caswell, ARNP (C); Kristin Schleifer (PM); Christian Ambler (PM); Department of Pediatrics, Yale University School of Medicine, New Haven, CT: Stuart A. Weinzimer, MD (PI); William V. Tamborlane, MD (I); Amy Steffen, BS (C); Kate Weyman, MSN (C); Melinda Zgorski, BSN (C); Jodie Ambrosino, PhD (I); Washington University in St. Louis, St. Louis,MO: Neil H. White, MD, CDE (PI); Ana Maria Arbelaez, MD, (I); Lucy Levandoski, PA-C (C); Angie Starnes, RN, BSN, CDE (C), Tamara Hershey, PhD (I). Coordinating Center: Jaeb Center for Health Research, Tampa, FL: Roy W. Beck, MD, PhD; Katrina J. Ruedy, MSPH; Craig Kollman, PhD; Peiyao Cheng, MPH; Beth Stevens; Nelly Njeru; Ryan Chapman, TJ Mouse. Image Coordinating Center: Allan L. Reiss, MD; Naama Barnea- Goraly, MD; Matthew J. Marzelli, BS; Paul M. Mazaika, PhD; Daniel X. Peng, BS. Cognitive Core: Tamara Hershey, PhD; Allison Cato, PhD; Emily Bihun, MA; Amal Al-Lozi, BA; Allison Bischoff, BA; Michaela Cuneo, BA; Aiden Bondurant, BA. Data and Safety Monitoring Board: Mark Sperling, MD; Dorothy M. Becker, MBBCh; Patricia Cleary, MS; Carla Greenbaum, MD; Antoinette Moran, MD. Publisher Copyright: {\textcopyright} Copyright The International Neuropsychological Society 2016.",

year = "2016",

month = jan,

day = "28",

doi = "10.1017/S1355617715001289",

language = "English (US)",

volume = "22",

pages = "293--302",

journal = "Journal of the International Neuropsychological Society",

issn = "1355-6177",

publisher = "Cambridge University Press",

number = "3",

}

TY - JOUR

T1 - Longitudinal Evaluation of Cognitive Functioning in Young Children with Type 1 Diabetes over 18 Months

AU - Cato, M. Allison

AU - Mauras, Nelly

AU - Mazaika, Paul

AU - Kollman, Craig

AU - Cheng, Peiyao

AU - Aye, Tandy

AU - Ambrosino, Jodie

AU - Beck, Roy W.

AU - Ruedy, Katrina J.

AU - Reiss, Allan L.

AU - Tansey, Michael

AU - White, Neil H.

AU - Hershey, Tamara

AU - Tsalikian, E.

AU - Coffey, J.

AU - Cabbage, J.

AU - Salamati, S.

AU - Conrad, A.

AU - Fox, L. A.

AU - Englert, K.

AU - Sikes, K.

AU - Ewen, T.

AU - Buckingham, B. A.

AU - Wilson, D. M.

AU - Aye, T.

AU - Caswell, K.

AU - Schleifer, K.

AU - Ambler, C.

AU - Weinzimer, S. A.

AU - Tamborlane, W. V.

AU - Steffen, A.

AU - Weyman, K.

AU - Zgorski, M.

AU - Ambrosino, J.

AU - Arbelaez, A. M.

AU - Levandoski, L.

AU - Starnes, A.

AU - Beck, R. W.

AU - Ruedy, J.

AU - Kollman, C.

AU - Cheng, P.

AU - Stevens, B.

AU - Njeru, N.

AU - Chapman, R.

AU - Mouse, T. J.

AU - Barnea-Goraly, N.

AU - Marzelli, M. J.

AU - Peng, D. X.

AU - Bihun, E.

AU - Al-Lozi, A.

AU - Bischoff, A.

AU - Cuneo, M.

AU - Bondurant, A.

AU - Sperling, M.

AU - Becker, D. M.

AU - Cleary, P.

AU - Greenbaum, C.

AU - Moran, A.

N1 - Funding Information: The authors thank the children and their families as well as the clinical and imaging staff at all of the investigator sites. We also thank our external collaborators for use of their imaging facilities, including University of California at San Francisco, El Camino Hospital, and University of Florida & Shands Jacksonville. We are also grateful to Karen Winer, MD, and Ellen Leschek, MD, at NIDDK for advice and support. This research was supported by funding from the NIH (DIRECNET R01 HD078463 U01 HD41890, HD41906-10, HD41908-10, HD41915, HD41918, HD56526) and UL1 RR024992. A. Cato, N. Mauras, P. Mazaika, C. Kollman, P. Cheng, T. Aye, J. Ambrosino, R. Beck, K. Ruedy, A. Reiss, M. Tansey, and T. Hershey report no conflict of interest. N.H. White reports receiving payment for consultancy from Novo Nordisk and Daiichi Sankyo and payments to his institution from Bristol-Myers Squibb for a research grant. The DirecNet Study Group: Clinical Centers: (Personnel are listed as (PI) for Principal Investigator, (I) for co-Investigator, (C) for Coordinators, and (PM) for Psychometrician.) Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA: Eva Tsalikian, MD (PI); Michael J. Tansey,MD(I); Julie Coffey, MSN (C); Joanne Cabbage (C); Sara Salamati (C); Amy Conrad, PhD (PM); Nemours Children’s Health System, Jacksonville, FL: Nelly Mauras, MD (PI); Larry A. Fox, MD (I); Allison Cato, PhD (I); Kim Englert, RN, BSN, CDE (C); Kaitlin Sikes, ARNP, MSN (C); Tina Ewen (C); Division of Pediatrics Endocrinology and Diabetes, Stanford University, Stanford, CA: Bruce A. Buckingham, MD(PI); Darrell M. Wilson, MD (I); Tandy Aye, MD (I); Kimberly Caswell, ARNP (C); Kristin Schleifer (PM); Christian Ambler (PM); Department of Pediatrics, Yale University School of Medicine, New Haven, CT: Stuart A. Weinzimer, MD (PI); William V. Tamborlane, MD (I); Amy Steffen, BS (C); Kate Weyman, MSN (C); Melinda Zgorski, BSN (C); Jodie Ambrosino, PhD (I); Washington University in St. Louis, St. Louis,MO: Neil H. White, MD, CDE (PI); Ana Maria Arbelaez, MD, (I); Lucy Levandoski, PA-C (C); Angie Starnes, RN, BSN, CDE (C), Tamara Hershey, PhD (I). Coordinating Center: Jaeb Center for Health Research, Tampa, FL: Roy W. Beck, MD, PhD; Katrina J. Ruedy, MSPH; Craig Kollman, PhD; Peiyao Cheng, MPH; Beth Stevens; Nelly Njeru; Ryan Chapman, TJ Mouse. Image Coordinating Center: Allan L. Reiss, MD; Naama Barnea- Goraly, MD; Matthew J. Marzelli, BS; Paul M. Mazaika, PhD; Daniel X. Peng, BS. Cognitive Core: Tamara Hershey, PhD; Allison Cato, PhD; Emily Bihun, MA; Amal Al-Lozi, BA; Allison Bischoff, BA; Michaela Cuneo, BA; Aiden Bondurant, BA. Data and Safety Monitoring Board: Mark Sperling, MD; Dorothy M. Becker, MBBCh; Patricia Cleary, MS; Carla Greenbaum, MD; Antoinette Moran, MD. Publisher Copyright: © Copyright The International Neuropsychological Society 2016.

PY - 2016/1/28

Y1 - 2016/1/28

N2 - Objectives: Decrements in cognitive function may already be evident in young children with type 1 diabetes (T1D). Here we report prospectively acquired cognitive results over 18 months in a large cohort of young children with and without T1D. Methods: A total of 144 children with T1D (mean HbA1c: 7.9%) and 70 age-matched healthy controls (mean age both groups 8.5 years; median diabetes duration 3.9 years; mean age of onset 4.1 years) underwent neuropsychological testing at baseline and after 18-months of follow-up. We hypothesized that group differences observed at baseline would be more pronounced after 18 months, particularly in those T1D patients with greatest exposure to glycemic extremes. Results: Cognitive domain scores did not differ between groups at the 18 month testing session and did not change differently between groups over the follow-up period. However, within the T1D group, a history of diabetic ketoacidosis (DKA) was correlated with lower Verbal IQ and greater hyperglycemia exposure (HbA1c area under the curve) was inversely correlated to executive functions test performance. In addition, those with a history of both types of exposure performed most poorly on measures of executive function. Conclusions: The subtle cognitive differences between T1D children and nondiabetic controls observed at baseline were not observed 18 months later. Within the T1D group, as at baseline, relationships between cognition (Verbal IQ and executive functions) and glycemic variables (chronic hyperglycemia and DKA history) were evident. Continued longitudinal study of this T1D cohort and their carefully matched healthy comparison group is planned.

AB - Objectives: Decrements in cognitive function may already be evident in young children with type 1 diabetes (T1D). Here we report prospectively acquired cognitive results over 18 months in a large cohort of young children with and without T1D. Methods: A total of 144 children with T1D (mean HbA1c: 7.9%) and 70 age-matched healthy controls (mean age both groups 8.5 years; median diabetes duration 3.9 years; mean age of onset 4.1 years) underwent neuropsychological testing at baseline and after 18-months of follow-up. We hypothesized that group differences observed at baseline would be more pronounced after 18 months, particularly in those T1D patients with greatest exposure to glycemic extremes. Results: Cognitive domain scores did not differ between groups at the 18 month testing session and did not change differently between groups over the follow-up period. However, within the T1D group, a history of diabetic ketoacidosis (DKA) was correlated with lower Verbal IQ and greater hyperglycemia exposure (HbA1c area under the curve) was inversely correlated to executive functions test performance. In addition, those with a history of both types of exposure performed most poorly on measures of executive function. Conclusions: The subtle cognitive differences between T1D children and nondiabetic controls observed at baseline were not observed 18 months later. Within the T1D group, as at baseline, relationships between cognition (Verbal IQ and executive functions) and glycemic variables (chronic hyperglycemia and DKA history) were evident. Continued longitudinal study of this T1D cohort and their carefully matched healthy comparison group is planned.

KW - Children

KW - Cognition

KW - Early onset

KW - Hyperglycemia

KW - Longitudinal

KW - T1D

UR - http://www.scopus.com/inward/record.url?scp=84959487891&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959487891&partnerID=8YFLogxK

U2 - 10.1017/S1355617715001289

DO - 10.1017/S1355617715001289

M3 - Article

C2 - 26786245

AN - SCOPUS:84959487891

SN - 1355-6177

VL - 22

SP - 293

EP - 302

JO - Journal of the International Neuropsychological Society

JF - Journal of the International Neuropsychological Society

IS - 3

ER -

Longitudinal Evaluation of Cognitive Functioning in Young Children with Type 1 Diabetes over 18 Months

Abstract

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