YOUNG people with diabetes have been shown to have a significantly higher risk of developing neurodegenerative diseases later in life, in a new study. Although previous studies have explored the link between adult-onset diabetes and risk of neurodegenerative disease, including Alzheimer’s disease (AD), little research has been done on the risk associated with youth-onset diabetes (Y-DM). Allison Shapiro, University of Colorado at Anschutz, Aurora, Colorado, USA, and team, aimed to investigate this connection.
Their study analysed the blood biomarkers of 50 patients (age at onset <20 years; 59% female), including 25 with Type 1 diabetes and 25 with Type 2 diabetes. These were randomly selected from the SEARCH for Diabetes in Youth Study, a multi-centre population-based registry and cohort. A further 46 young people with no diabetes were included in the study as controls. A subset of the groups with and without Y-DM additionally underwent PET scans to quantify brain amyloid and tau densities in AD-sensitive brain regions.
The research team found that adolescents exhibited lower plasma levels of Aβ40, Aβ42, and glial fibrillary acidic protein, as well as higher pTau181, compared to controls (p<0.05); a pattern which continued into adulthood (p<0.001). All biomarkers measured also showed significant increases from adolescence to adulthood in Y-DM (p<0.01), though no significant differences in brain amyloid or tau were noted between Y-DM and controls in adulthood. This preliminary evidence suggests that preclinical AD neuropathology is present in young people with Y-DM, which Shapiro and colleagues highlighted may indicate a potential increased risk of developing neurodegenerative diseases later in life.
Shapiro concluded that, though these results do not definitively show a link between AD and Y-DM, “this trajectory is concerning.” She added that cognitive testing, which is considered for older adults with diabetes, might benefit younger people too. “The field of diabetes care is beginning to recognise the importance of cognitive testing as a part of clinical follow-up,” Shapiro commented. “And it should be something we consider in youth-onset diabetes as well.”
Reference
Shapiro ALB et al. Biomarkers of neurodegeneration and Alzheimer’s disease neuropathology in adolescents and young adults with youth-onset Type 1 or Type 2 diabetes: a proof-of-concept study. Endocrines. 2024;5(2):197-213.
