Journal article
Impact of Type 1 Diabetes in the Developing Brain in Children: A Longitudinal Study
Diabetes care, Vol.44(4), pp.983-992
04/01/2021
DOI: 10.2337/dc20-2125
PMCID: PMC7985430
PMID: 33568403
Abstract
OBJECTIVE To assess whether previously observed brain and cognitive differences between children with type 1 diabetes and control subjects without diabetes persist, worsen, or improve as children grow into puberty and whether differences are associated with hyperglycemia. RESEARCH DESIGN AND METHODS One hundred forty-four children with type 1 diabetes and 72 age-matched control subjects without diabetes (mean +/- SD age at baseline 7.0 +/- 1.7 years, 46% female) had unsedated MRI and cognitive testing up to four times over 6.4 +/- 0.4 (range 5.3-7.8) years; HbA(1c) and continuous glucose monitoring were done quarterly. FreeSurfer-derived brain volumes and cognitive metrics assessed longitudinally were compared between groups using mixed-effects models at 6, 8, 10, and 12 years. Correlations with glycemia were performed. RESULTS Total brain, gray, and white matter volumes and full-scale and verbal intelligence quotients (IQs) were lower in the diabetes group at 6, 8, 10, and 12 years, with estimated group differences in full-scale IQ of -4.15, -3.81, -3.46, and -3.11, respectively (P < 0.05), and total brain volume differences of -15,410, -21,159, -25,548, and -28,577 mm(3) at 6, 8, 10, and 12 years, respectively (P < 0.05). Differences at baseline persisted or increased over time, and brain volumes and cognitive scores negatively correlated with a life-long HbA(1c) index and higher sensor glucose in diabetes. CONCLUSIONS Detectable changes in brain volumes and cognitive scores persist over time in children with early-onset type 1 diabetes followed longitudinally; these differences are associated with metrics of hyperglycemia. Whether these changes can be reversed with scrupulous diabetes control requires further study. These longitudinal data support the hypothesis that the brain is a target of diabetes complications in young children.
Details
- Title: Subtitle
- Impact of Type 1 Diabetes in the Developing Brain in Children: A Longitudinal Study
- Creators
- Nelly Mauras - Nemours Children's Health SystemBruce Buckingham - Stanford UniversityNeil H. White - Washington University in St. LouisEva Tsalikian - University of IowaStuart A. Weinzimer - Yale UniversityBooil Jo - Stanford UniversityAllison Cato - Nemours Children's Health SystemLarry A. Fox - Nemours Children's Health SystemTandy Aye - Stanford UniversityAna Maria Arbelaez - Washington University in St. LouisTamara Hershey - Washington University in St. LouisMichael Tansey - Univ Iowa, Stead Family Dept Pediat, Div Endocrinol & Diabet, Iowa City, IA USAWilliam Tamborlane - Yale UniversityLara C. Foland-Ross - Stanford UniversityHanyang Shen - Stanford UniversityKimberly Englert - Nemours Children's Health SystemPaul Mazaika - Stanford UniversityMatthew Marzelli - Stanford UniversityAllan L. Reiss - Stanford UniversityDiabetes Research in Children Network (DirecNet)
- Resource Type
- Journal article
- Publication Details
- Diabetes care, Vol.44(4), pp.983-992
- DOI
- 10.2337/dc20-2125
- PMID
- 33568403
- PMCID
- PMC7985430
- NLM abbreviation
- Diabetes Care
- ISSN
- 0149-5992
- eISSN
- 1935-5548
- Publisher
- Amer Diabetes Assoc
- Number of pages
- 10
- Grant note
- R01-HD-078463; U01-HD-41908; U01-HD-41915; U01-HD-41918; U01-HD-56526; U01-HD-41906 / National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health and Human Development; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) U54-HD-087011; UL1-TR-001085 / U.S. Department of Health and Human Services
- Language
- English
- Date published
- 04/01/2021
- Academic Unit
- Endocrinology and Diabetes; Stead Family Department of Pediatrics; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9984353930802771
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