How Does Type 1 Diabetes Affect Children's Brains?

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How Does Type 1 Diabetes Affect Children’s Brains?
How Does Type 1 Diabetes Affect Children’s Brains?

A new study published in Diabetes has implicated chronic exposure to hyperglycemia in slower growth of gray and white matter in the brains of young children with type 1 diabetes.

Researchers, however, did not observe significant differences in cognitive and executive functions scores between children with type 1 diabetes and healthy, age-matched controls.

For the study, the researchers evaluated 144 children aged 4 to 9 years with type 1 diabetes and 72 healthy, age-matched controls. They assessed brain structure and function using MRI scans and comprehensive neurocognitive tests at baseline and 18 months. Participants also underwent continuous glucose monitoring and HbA1c testing quarterly.

In children with type 1 diabetes, overall and regional brain growth was slower than in those without the disease, according to study results. Gray matter regions that showed less growth in the type 1 diabetes group included left precuneus, right temporal, frontal and parietal lobes, and the right medial-frontal cortex. White matter areas that showed less growth included splenium of the corpus callosum, bilateral superior-parietal lobe, bilateral anterior forceps and inferior-frontal fasciculus.

Exposure to hyperglycemia and glucose variability, but not hypoglycemia, was linked to the brain changes evident in children with type 1 diabetes.

“We believe the results are remarkable and show the potential vulnerability of the young developing brain to abnormally elevated glucose levels,” Nelly Mauras, MD, lead author of the article and head of pediatric endocrinology at Nemours Children's Clinic in Jacksonville, Florida, said in a press release.

Although the researchers did not find cognitive differences in the children with type 1 diabetes during the study, they are leading a continued study with the same children and will look for those types of changes.

“This is the thing that parents always worry about when it comes to a child with a chronic illness,” study co-author Karen Winer, MD, pediatric endocrinologist at the National Institutes of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development, said in the release. “Does it affect their brain? The good news here is that there are some viable solutions on the horizon that parents should be aware of.”

These include new technologies that allow for quicker, more accurate and continuous monitoring of blood glucose.

“The future of diabetes is very promising because technology has come so far,” Dr. Winer said.

Reference

  1. Mauras N et al. Diabetes. 2014;doi: 10.2337/db14-1445.
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