Glycemic Extremes in Type 1 Diabetes Can Impair Brain Development

Patients with type 1 diabetes (T1D) who experience hyperglycemia or severe hypoglycemia in their youth are at risk of impaired brain development, a new study finds.

The study, published online late last month in Diabetes, aimed to refine our understanding of the impact of T1D on central nervous system development. Retrospective studies have indicated that experiencing glycemic extremes during development can impede brain development, but they have been unable to isolate particular regions of the brain that develop differently under these conditions.

For the current study, researchers performed a longitudinal prospective structural neuroimaging study of 75 youth with T1DM and 25 of their nondiabetic siblings. (Both groups had a mean age of 12.5.) Each study participant was scanned twice, with two years separating the scans. Blood glucose control measurements (i.e., A1C, glucose meter results, and reports of severe hypoglycemia) were collected at the two-year follow-up. Sophisticated image-registration algorithms were performed, followed by whole brain and voxel-wise statistical analyses of the change in gray and white matter volume.

The researchers found that the T1D and nondiabetic groups did not differ in whole brain or voxel-wise change over the two-year study period. However, within the T1D group, greater hyperglycemia was correlated with greater decrease in whole brain gray matter, and severe hypoglycemia was correlated with greater decrease in occipital/parietal white matter volume. The results suggest that for those with T1D, increased hyperglycemia and severe hypoglycemia can cause deviations from normal brain development.

Source

Prospectively Determined Impact of Type 1 Diabetes on Brain Volume During Development (abstract) [Diabetes]