cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2025-40-4-37-44cardiotomsk-2908Research ArticleОБЗОРЫREVIEWSФакторы риска когнитивных нарушений при сахарном диабете 1-го типа у детей и подростков: патофизиологические аспекты (обзор литературы)Risk factors for cognitive impairments in children and adolescents with type 1 diabetes mellitus: pathophysiological aspects (literature review)https://orcid.org/0009-0001-0303-9950КамаеваК. С.KamaevaK. S.

Камаева Ксения Савровна - студент, СтГМУ Минздрава России.

355017, Ставрополь, ул. Мира, 310

Ksenia S. Kamaeva – student.

310, Mira str., Stavropol, 355017

kamaevaksusha@mail.ruhttps://orcid.org/0000-0003-4705-3823БыковЮ. В.BykovYu. V.

Быков Юрий Витальевич - канд. мед. наук, доцент кафедры анестезиологии и реаниматологии с курсом ДПО, СтГМУ Минздрава России.

355017, Ставрополь, ул. Мира, 310

Yuri V. Bykov - Cand. Sci. (Med.) Assistant Professor, Department of Anesthesiology, Resuscitation and Emergency Medicine.

310, Mira str., Stavropol, 355017

yubykov@gmail.comСтавропольский государственный медицинский университет Министерства здравоохранения Российской Федерации (СтГМУ Минздрава России)РоссияStavropol State Medical UniversityRussian Federation2025121220254043744Copyright © Камаева К.С., Быков Ю.В., 20252025Камаева К.С., Быков Ю.В.Kamaeva K.S., Bykov Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/2908

Сахарный диабет (СД) 1-го типа у детей и подростков сопровождается не только метаболическими нарушениями, но и формированием когнитивных расстройств, которые на начальных этапах могут протекать субклинически. Эти нарушения отражают поражение центральной нервной системы, которое развивается под действием множественных патофизиологических механизмов. Современные исследования демонстрируют, что на когнитивный статус детей с СД 1-го типа влияет сочетание острых и хронических факторов, включая эпизоды гипои гипергликемии, диабетический кетоацидоз, длительное течение заболевания и нарушение гликемического контроля.

Цель обзора. Обобщение литературных данных о механизмах формирования когнитивных нарушений при СД 1-го типа, а также возможностях их ранней диагностики и профилактики. Обсуждаются роль нейровоспаления, оксидативного стресса, изменений транспортеров глюкозы и нейрогенеза, микрососудистых осложнений, дисбактериоза кишечника и коморбидных психических состояний в патогенезе когнитивной дисфункции. Также рассматриваются сложности стандартизированной оценки когнитивного статуса в педиатрической популяции, возможности использования лабораторных и нейровизуализационных маркеров, а также перспективы их внедрения в клиническую практику. Внимание уделяется влиянию когнитивных нарушений на обучение, социальную адаптацию и качество жизни пациентов. Представленные данные подчёркивают необходимость разработки персонализированных стратегий профилактики и вмешательства. Когнитивные расстройства при СД 1-го типа рассматриваются как один из ведущих факторов, определяющих долгосрочный прогноз и адаптационные ресурсы пациентов молодого возраста.

Type 1 diabetes mellitus (T1DM) in children and adolescents is associated not only with metabolic disturbances but also with the development of cognitive impairments, which may initially present subclinically. These impairments reflect central nervous system involvement driven by a variety of pathophysiological mechanisms. Recent studies have demonstrated that the cognitive status of children with T1DM is influenced by both acute and chronic factors, including episodes of hypoand hyperglycemia, diabetic ketoacidosis, disease duration, and poor glycemic control.

Aim. Summarize current literature on the mechanisms underlying cognitive impairment in T1DM, as well as the possibilities for early diagnosis and prevention. The roles of neuroinflammation, oxidative stress, altered glucose transporter function, impaired neurogenesis, microvascular complications, gut dysbiosis, and psychiatric comorbidities in the pathogenesis of cerebral dysfunction are discussed. Particular attention is given to the methodological challenges of assessing cognitive status in the pediatric population, the potential use of laboratory and neuroimaging markers, and their clinical applicability. The review also highlights the impact of cognitive impairment on learning, social adaptation, and quality of life in patients. The data presented emphasize the need for the development of personalized strategies for prevention and intervention. Cognitive disturbances in T1DM are increasingly recognized as a major factor influencing long-term prognosis and the adaptive capacity of young patients.

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The authors declare that there are no conflicts of interest present.