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Color visual evoked potentials in children with type 1 diabetes: relationship to metabolic control
Yesmino T Elia1, Denis Daneman, Joanne Rovet
1Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children and University of Toronto, Canada.
Insights
Pubertal status, not blood sugar control (HbA1c), impacts blue-yellow color vision in children with type 1 diabetes (T1D). Puberty delays short-wavelength visual evoked potential (VEP) responses in these children.
Area of Science:
- Ophthalmology
- Pediatric Endocrinology
- Neuroscience
Background:
- Type 1 diabetes (T1D) can affect visual pathways.
- Metabolic control, indicated by HbA1c, is crucial for managing T1D complications.
- Chromatic visual mechanisms may be sensitive indicators of early neuro-visual changes in T1D.
Purpose of the Study:
- To investigate the relationship between glycemic control (HbA1c) and color vision using visual evoked potentials (VEPs) in children with T1D.
- To assess if metabolic control affects short-wavelength (S-VEP) and long-medium-wavelength (LM-VEP) visual pathways.
Main Methods:
- Fifty children with T1D and 33 controls (ages 6-12.9) underwent VEP testing.
- Color stimuli (S-VEP, LM-VEP) and achromatic stimuli were presented.
- VEP latency was analyzed in relation to HbA1c and pubertal status using ANCOVA regression.
Main Results:
- No significant association was found between HbA1c levels and S-VEP, LM-VEP, or achromatic VEP latency.
- Pubertal status significantly impacted S-VEP latency (P=0.0114).
- Pubertal children with T1D exhibited delayed S-VEP latency (mean 9.5 ms) compared to prepubertal children, with no significant difference between T1D and control groups regarding this effect.
Conclusions:
- Pubertal status, rather than HbA1c, selectively influences S-VEP latency in preteen children with T1D.
- Further research is needed to track S-VEP latency changes over time in pubertal T1D children.
- Delayed S-VEP latency may serve as a potential predictive marker for diabetic retinopathy development.
Purpose:
To examine the association between metabolic control (HbA(1c)) and the chromatic mechanisms of children with type 1 diabetes (T1D), by using the color visual evoked potential (VEP).
Methods:
Fifty children with T1D (age range, 6-12.9 years) and 33 age-matched control subjects were tested. VEPs were recorded by placing five electrodes on the scalp according to the International 10/20 System of Electrode Placement. Active electrodes O1, O2, and Oz were placed over the visual cortex. Short-wavelength (S), and long- and medium-wavelength (LM) color stimuli consisted of vertical, photometric isoluminant (1 cyc/deg) gratings presented in a pattern onset (100 ms)-offset (400 ms) mode. Achromatic vertical gratings were presented at 3 cyc/deg. Primary outcome measure was VEP latency. The relationship between S, LM, and achromatic VEP latency, and HbA(1c) was determined by ANCOVA regression.
Results:
S-, LM-, achromatic VEP latencies were not associated significantly with HbA(1c). Pubertal status, however, was associated significantly (P = 0.0114) and selectively with S-VEP latency. Pubertal children with T1D had delayed (mean delay, 9.5 ms) S-VEP latencies when compared with the prepubertal children with T1D. However, there was no statistically significant difference (P = 0.1573) in the effect of pubertal status on S-VEP latency between the T1D and control groups.
Conclusions:
Pubertal status rather than HbA(1c) appears to affect selectively the S-VEP latency of preteen children with T1D. Further study is warranted to determine whether the delay in S-VEP latency in pubertal children with T1D changes over time and whether this change could be a predictive marker for future development of background diabetic retinopathy.
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