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Study: Effects of Type I Diabetes on a Young Child's Brain

I'm posting chunks from a recent study that can be found on Diabetes Care (American Diabetes Association) and blurbs from a corresponding article about the study, from Reuters Health. Study text is in the left column, Reuters on the right.

I don't believe that this information should lead you to more worry (Though it likely will) but I do believe that the parents of young children, who live with type I diabetes, should be aware of the study findings. These articles are not fun to read for many reasons, but I found them to be full of the kind of information that helps me to (hopefully) avoid long-term complications for Arden.

If you are currently struggling with BGs or generally feeling down about type I - seriously - bookmark this and save it for a better day - even though you'll likely not find much of the information surprising, it is a somber reminder. My thoughts, are as always, with you and your families. - Scott

Links to the complete articles are included below, at the end of each column. 



Alterations in White Matter Structure in Young Children With Type 1 Diabetes

Study Objective: To investigate whether type 1 diabetes affects white matter (WM) structure in a large sample of young children.

Results: Between-group analysis showed that children with type 1 diabetes had significantly reduced axial diffusivity (AD) in widespread brain regions compared with control subjects. Within the type 1 diabetes group, earlier onset of diabetes was associated with increased radial diffusivity (RD) and longer duration was associated with reduced AD, reduced RD, and increased fractional anisotropy (FA). In addition, HbA1c values were significantly negatively associated with FA values and were positively associated with RD values in widespread brain regions. Significant associations of AD, RD, and FA were found for CGM measures of hyperglycemia and glucose variability but not for hypoglycemia. Finally, we observed a significant association between WM structure and cognitive ability in children with type 1 diabetes but not in control subjects.

Conclusions: These results suggest vulnerability of the developing brain in young children to effects of type 1 diabetes associated with chronic hyperglycemia and glucose variability.

The entire study can be found here, it includes a significant introduction, an outline of research design and methods, as well as a description of the participants, CGM use in the study, data analysis and much more.

Chronic hyperglycemia, glucose variability may affect children's brains

By Lorraine L. Janeczko
NEW YORK (Reuters Health)

"Chronic hyperglycemia and glucose variability could impact the brains of young children with type 1 diabetes, new research suggests."

"In what the authors call the largest study to date investigating white matter structure in young children with type 1 diabetes, diabetic children had widespread and significant differences in their white matter microstructure compared with nondiabetic controls."

"Compared to controls, children with type 1 diabetes had significantly reduced axial diffusivity (AD) in their frontal, temporal, parietal, and occipital lobes. Earlier diabetes onset was associated with increased radial diffusivity (RD), and longer duration was associated with reduced AD, reduced RD, and increased fractional anisotropy (FA) (all P<0.05)."

"While many children may not show overt complications from these differences in neural structure, some do have difficulties with processing speed, memory, learning, and complex cognitive functions which can be associated with poor neuronal function," she said.

"I believe that these effects could be improved with good glycemic control, although an empirical investigation would help to answer this question. It seems that in the quest to prevent hypoglycemia in children with diabetes, there has been an increase in hyperglycemia in many children. It may be the case that a balance needs to be struck between the two extremes, perhaps with better methods of glucose monitoring."

The entire Reuters article can be found here