Abstract
The rise of youth onset Type two Diabetes Mellitus (T2DM) in recent years has brought with it more severe and rapid onset of diabetes complications in affected youth populations. Neurological, cognitive, and cerebrovascular complications have been shown to occur in adult-onset T2DM, youth-onset type one Diabetes mellitus (T1DM), and likely occur in adolescent-onset T2DM, thus requiring attention by healthcare professionals.
The aim of this integrative review is to discuss current evidence pertaining to the impacts of adolescent-onset T2DM on neurological, cerebrovascular, and cognitive structure and function in adolescents using a systematic approach to search the following five medical and scientific databases, pubMed, CINAHL, Ovid, Scopus, and proQuest. Included literature was limited to peer-reviewed primary studies using quantitative methodology involving individuals with adolescent-onset T2DM (mean onset 10-19 years) in their sample populations. Whittemore and Knafl's (2005) constant comparison method is used to identify themes and develop key categories relevant to the research question. Categories identified include optic function, peripheral neuropathy, cardiac autonomic function, cognitive function, morphological changes. Impaired retinal function was evident early in pathogenesis, retinopathy and diabetic peripheral neuropathy (DpN) were highly prevalent, while there were signs of cardiac autonomic dysfunction and risk of cardiac autonomic neuropathy, cognitive impairment, and grey matter/ white matter changes in this population.
The current review also found evidence for retinopathy and DpN in this population being associated with disease duration. The role of HbA1c in the development of complications, however, remains unclear, with exploration into the role of HbA1c variability required in future research.