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Behavioral Development of Episodic Memory in Children with Type 1 Diabetes

Over the past several years, we have been investigating the development of episodic memory in children with Type I Diabetes Mellitus (T1DM). Several complications of T1DM seem to interfere with memory functioning. One such complication is diabetic ketoacidosis (DKA), a very frequent complication of T1DM, is a state of inadequate insulin levels resulting in metabolic decompensation with high blood sugar, hyperosmolality, and hepatic ketone production resulting in acidosis. Twenty-five to forty percent of children with new-onset of DMI experience DKA; DKA may also be the consequence of illness, poor compliance, or malfunction of diabetes care equipment (e.g., insulin pumps).

We provided evidence for the first time that DKA results in specific deficits in episodic memory (Ghetti et al, 2010) and showed that children who were younger when they experienced DKA exhibited stronger deficits, while subjects of children who were older when they experienced DKA and were tested after a few years since DKA seem to be spared from the deficits. We are currently attempting to tease apart the effects of age at DKA from the effects of time since DKA; an understanding of these effects has important implications for understanding the developmental course of episodic memory in this population. In additional, we are collaborating in a large, multi-site clinical trial to examine the effects of DKA treatment on memory and cognitive function. Finally, an upcoming study will examine the neural correlates associated with memory deficits in children who have experienced DKA.