Psychoorganic Syndrome In Type 1 Diabetes Mellitus: A Concomitant Disease Or A Complication Of Diabetes?

Psychoorganic syndrome (POS), also known as encephalopathy, is characterized by cognitive decline, emotional incontinence (emotional lability), and asthenic symptoms. It can develop as a result of a number of exogenous and endogenous factors, and despite the use of the term "diabetic encephalopathy", evidence for the existence of a specific diabetic genesis of POS remains limited. The review provides a detailed history of the term "POS" and its definition, the components of POS and its possible causes, the pros and cons of the existence of POS of diabetic genesis. The likelihood of the influence of dysglycemia on the development of POS and changes in the brain in patients with type 1 diabetes mellitus (T1DM) according to neuroimaging data, as well as their relationship with each other and with other clinical parameters, including the age of manifestation of DM, disease duration, acute complications of DM, diabetic retinopathy as a marker of long-term exposure to hyperglycemia are discussed. In young adults with T1DM, cognitive function indicators are within the age-appropriate range, and associations with the severity of hyperglycemia or other diabetes complications are not reproduced in large studies. Analysis of neuroimaging and pathomorphological data also does not provide convincing evidence of changes in brain structures unique to T1DM. Thus, the issue of POS (encephalopathy) in T1DM remains insufficiently studied and controversial. Current data do not allow us to unambiguously accept the opinion about the specific diabetic nature of POS in T1DM. Further studies are needed to determine the contribution of diabetes and associated factors to the development of POS, including histological data.