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Longitudinal assessment of hippocampus structure in children with type 1 diabetes

Lara C Foland-Ross1, Allan L Reiss1,2,3, Paul K Mazaika1

  • 1Department of Psychiatry and Behavioral Sciences, Center for Interdisciplinary Brain Sciences Research, Stanford University, Stanford, California.

Pediatric Diabetes
|April 21, 2018
PubMed

Insights

Children with type 1 diabetes (T1D) show slower hippocampus growth linked to high blood sugar (hyperglycemia) and variability. This suggests current T1D management might not optimize brain development in young patients.

Area of Science:

  • Neuroscience
  • Pediatric Endocrinology
  • Developmental Biology

Background:

  • Children with type 1 diabetes (T1D) may exhibit subtle cognitive differences compared to healthy peers.
  • The underlying neural mechanisms for these cognitive alterations are not fully understood but may involve the impact of dysglycemia on the developing brain.

Purpose of the Study:

  • To investigate longitudinal changes in hippocampus volume in young children diagnosed with early-onset T1D.
  • To examine the influence of diabetes and glycemic exposure on hippocampal volume and its growth trajectory.

Main Methods:

  • Acquired structural magnetic resonance imaging (MRI) data from 142 children with T1D and 65 age-matched controls (aged 4-10 years at baseline).
  • Collected data at two time points, 18 months apart, to assess longitudinal changes.
  • Analyzed the association between glycemic control metrics (interval HbA1c, MAGE) and hippocampus growth in T1D.

Main Results:

  • No significant difference in longitudinal hippocampus growth was observed between children with T1D and healthy controls.
  • Slower hippocampus growth in children with T1D was correlated with increased exposure to hyperglycemia (interval HbA1c) and greater glycemic variability (MAGE).
  • These findings suggest that glycemic control impacts brain development in T1D.

Conclusions:

  • Current T1D management strategies that permit some hyperglycemia to avoid hypoglycemia may not be optimal for developing brains.
  • Further research into factors affecting neural and cognitive development in children with T1D is crucial for mitigating diabetes-related adverse effects.

Keywords:
blood glucosebrainhippocampushyperglycemiatype 1 diabetes mellitus

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