Journal article
Impact of Early Diabetic Ketoacidosis on the Developing Brain
Diabetes care, Vol.42(3), pp.443-449
03/2019
DOI: 10.2337/dc18-1405
PMCID: PMC6385695
PMID: 30573652
Abstract
This study examined whether a history of diabetic ketoacidosis (DKA) is associated with changes in longitudinal cognitive and brain development in young children with type 1 diabetes.
Cognitive and brain imaging data were analyzed from 144 children with type 1 diabetes, ages 4 to <10 years, who participated in an observational study of the Diabetes Research in Children Network (DirecNet). Participants were grouped according to history of DKA severity (none/mild or moderate/severe). Each participant had unsedated MRI scans and cognitive testing at baseline and 18 months.
In 48 of 51 subjects, the DKA event occurred at the time of onset, at an average of 2.9 years before study entry. The moderate/severe DKA group gained more total and regional white and gray matter volume over the observed 18 months compared with the none/mild group. When matched by age at time of enrollment and average HbA
during the 18-month interval, participants who had a history of moderate/severe DKA compared with none/mild DKA were observed to have significantly lower Full Scale Intelligence Quotient scores and cognitive performance on the Detectability and Commission subtests of the Conners' Continuous Performance Test II and the Dot Locations subtest of the Children's Memory Scale.
A single episode of moderate/severe DKA in young children at diagnosis is associated with lower cognitive scores and altered brain growth. Further studies are needed to assess whether earlier diagnosis of type 1 diabetes and prevention of DKA may reduce the long-term effect of ketoacidosis on the developing brain.
Details
- Title: Subtitle
- Impact of Early Diabetic Ketoacidosis on the Developing Brain
- Creators
- Tandy Aye - Division of Pediatric Endocrinology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA taye@stanford.eduPaul K Mazaika - Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CANelly Mauras - Division of Pediatric Endocrinology, Department of Pediatrics, Nemours Children's Health System, Jacksonville, FLMatthew J Marzelli - Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CAHanyang Shen - Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CATamara Hershey - Departments of Psychiatry and Radiology, Washington University School of Medicine, St. Louis, MOAllison Cato - Division of Neurology, Department of Pediatrics, Nemours Children's Health System, Jacksonville, FLStuart A Weinzimer - Section of Pediatric Endocrinology, Department of Pediatrics, Yale University, New Haven, CTNeil H White - Division of Endocrinology and Diabetes, Department of Pediatrics, Washington University School of Medicine, St. Louis, MOEva Tsalikian - Division of Endocrinology and Diabetes, Stead Family Department of Pediatrics, University of Iowa, Iowa City, IABooil Jo - Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CAAllan L ReissDiabetes Research in Children Network (DirecNet) Study Group
- Resource Type
- Journal article
- Publication Details
- Diabetes care, Vol.42(3), pp.443-449
- DOI
- 10.2337/dc18-1405
- PMID
- 30573652
- PMCID
- PMC6385695
- ISSN
- 0149-5992
- eISSN
- 1935-5548
- Grant note
- UL1 TR002345 / NCATS NIH HHS
- Language
- English
- Date published
- 03/2019
- Academic Unit
- Stead Family Department of Pediatrics; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984093313502771
Metrics
18 Record Views