CHILDREN with Type 1 diabetes (T1D) have shown slower brain growth than children without the disease.
Frequent exposure to hyperglycaemia afflicting diabetic children causes the inhibition of brain development, and children with T1D demonstrated slower growth of white and grey matter in various regions, including visual-spatial processing, executive functions, and memory, compared to children without T1D. This was explored in a study evaluating children with diabetes between 4 and 9 years of age, which used structural magnetic resonance imaging and cognitive tests alongside blood sugar monitoring. A surprising finding of the study was that there was no detectable differences in cognitive functions between both groups at 18 months.
These findings put the spotlight on T1D symptom awareness; a recent survey highlighted that fewer than one in six parents would be able to identify T1D symptoms in their children. The dangers of late diagnosis are already clear, with T1D often not recognised until the development of complications such as diabetic ketoacidosis, but the neurological setback seen in children with T1D further underlines the perils of avoiding early diagnosis.
Dr Nelly Mauras, lead study author and Chief, Division of Endocrinology, Diabetes and Metabolism, Nemours Children’s Clinic, Jacksonville, Florida, USA said: “Our results show the potential vulnerability of young developing brains to abnormally elevated glucose levels even when the diabetes duration has been relatively brief.
“Despite the best efforts of parents and diabetes care team, about 50% of all blood glucose concentrations during the study were measured in the high range. Remarkably, the cognitive tests remained normal, but whether these observed changes will ultimately impact brain function will need further study.
“As better technology develops, we hope to determine if the differences observed with brain imaging can improve with better glucose control.”
The researchers will be able to perform similar testing on the same children throughout puberty, thanks to sustained funding from the National Institute of Child Health and Human Development.