» Articles » PMID: 21562318

The Feasibility of Detecting Neuropsychologic and Neuroanatomic Effects of Type 1 Diabetes in Young Children

Overview
Journal Diabetes Care
Specialty Endocrinology
Date 2011 May 13
PMID 21562318
Citations 38
Authors
Affiliations
Soon will be listed here.
Abstract

Objective: To determine if frequent exposures to hypoglycemia and hyperglycemia during early childhood lead to neurocognitive deficits and changes in brain anatomy.

Research Design And Methods: In this feasibility, cross-sectional study, young children, aged 3 to 10 years, with type 1 diabetes and age- and sex-matched healthy control (HC) subjects completed neuropsychologic (NP) testing and magnetic resonance imaging (MRI) scans of the brain.

Results: NP testing and MRI scanning was successfully completed in 98% of the type 1 diabetic and 93% of the HC children. A significant negative relationship between HbA1c and Wechsler Intelligence Scale for Children (WISC) verbal comprehension was observed. WISC index scores were significantly reduced in type 1 diabetic subjects who had experienced seizures. White matter volume did not show the expected increase with age in children with type 1 diabetes compared with HC children (diagnosis by age interaction, P=0.005). A similar trend was detected for hippocampal volume. Children with type 1 diabetes who had experienced seizures showed significantly reduced gray matter and white matter volumes relative to children with type 1 diabetes who had not experienced seizures.

Conclusions: It is feasible to perform MRI and NP testing in young children with type 1 diabetes. Further, early signs of neuroanatomic variation may be present in this population. Larger cross-sectional and longitudinal studies of neurocognitive function and neuroanatomy are needed to define the effect of type 1 diabetes on the developing brain.

Citing Articles

Missed meal boluses and poorer glycemic control impact on neurocognitive function may be associated with white matter integrity in adolescents with type 1 diabetes.

Litmanovitch E, Geva R, Leshem A, Lezinger M, Heyman E, Gidron M Front Endocrinol (Lausanne). 2023; 14:1141085.

PMID: 37091855 PMC: 10113499. DOI: 10.3389/fendo.2023.1141085.


The Advanced Diabetes Technologies for Reduction of the Frequency of Hypoglycemia and Minimizing the Occurrence of Severe Hypoglycemia in Children and Adolescents with Type 1 Diabetes.

Urakami T J Clin Med. 2023; 12(3).

PMID: 36769430 PMC: 9917934. DOI: 10.3390/jcm12030781.


ISPAD Clinical Practice Consensus Guidelines 2022: Assessment and management of hypoglycemia in children and adolescents with diabetes.

Abraham M, Karges B, Dovc K, Naranjo D, Arbelaez A, Mbogo J Pediatr Diabetes. 2022; 23(8):1322-1340.

PMID: 36537534 PMC: 10107518. DOI: 10.1111/pedi.13443.


Epilepsy, Immunity and Neuropsychiatric Disorders.

Fortunato F, Giugno A, Sammarra I, Labate A, Gambardella A Curr Neuropharmacol. 2022; 21(8):1714-1735.

PMID: 35794773 PMC: 10514543. DOI: 10.2174/1570159X20666220706094651.


Comparison of the clinical effects of intermittently scanned and real-time continuous glucose monitoring in children and adolescents with type 1 diabetes: A retrospective cohort study.

Urakami T, Terada H, Yoshida K, Kuwabara R, Mine Y, Aoki M J Diabetes Investig. 2022; 13(10):1745-1752.

PMID: 35532954 PMC: 9533045. DOI: 10.1111/jdi.13830.


References
1.
Ryan C . Does moderately severe hypoglycemia cause cognitive dysfunction in children?. Pediatr Diabetes. 2004; 5(2):59-62. DOI: 10.1111/j.1399-543X.2004.00044.x. View

2.
Kaufman F, Epport K, Engilman R, Halvorson M . Neurocognitive functioning in children diagnosed with diabetes before age 10 years. J Diabetes Complications. 1999; 13(1):31-8. DOI: 10.1016/s1056-8727(98)00029-4. View

3.
Cox D, Kovatchev B, Gonder-Frederick L, Summers K, McCall A, Grimm K . Relationships between hyperglycemia and cognitive performance among adults with type 1 and type 2 diabetes. Diabetes Care. 2004; 28(1):71-7. DOI: 10.2337/diacare.28.1.71. View

4.
Ryan C, Geckle M, Orchard T . Cognitive efficiency declines over time in adults with Type 1 diabetes: effects of micro- and macrovascular complications. Diabetologia. 2003; 46(7):940-8. DOI: 10.1007/s00125-003-1128-2. View

5.
Bronen R . MR of mesial temporal sclerosis: how much is enough?. AJNR Am J Neuroradiol. 1998; 19(1):15-8. PMC: 8337351. View