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Brain Health in Children with Type 1 Diabetes: Risk and Protective Factors

Sarah S Jaser1, Lori C Jordan2,3,4

  • 1Department of Pediatrics, Vanderbilt University Medical Center, 2525 West End Ave., Suite 1200, Nashville, TN, 37203, USA. sarah.jaser@vumc.org.

Current Diabetes Reports
|March 14, 2021
PubMed

Insights

Hyperglycemia and time in range are key for brain development in children with type 1 diabetes (T1D). Diabetic ketoacidosis (DKA) at diagnosis poses risks, while good sleep and device use may be protective.

Area of Science:

  • Pediatric Endocrinology
  • Neuroscience
  • Metabolic Disorders

Background:

  • Type 1 Diabetes (T1D) affects children globally.
  • Neurocognitive complications are a significant concern in pediatric T1D.
  • Understanding risk and protective factors is crucial for early intervention.

Purpose of the Study:

  • To synthesize current research on neurocognitive outcomes in children with T1D.
  • To identify key risk factors impacting brain development.
  • To highlight potential protective factors for improved neurocognitive health.

Main Methods:

  • Systematic review of existing literature.
  • Analysis of studies focusing on hyperglycemia, hypoglycemia, and glycemic control.
  • Examination of neuroimaging and neurocognitive assessment data.

Main Results:

  • Hyperglycemia and time in range appear more critical than hypoglycemia for brain development.
  • Diabetic ketoacidosis (DKA) at diagnosis is linked to executive function and memory deficits.
  • Advanced MRI shows white matter microstructure differences in children diagnosed with DKA.
  • Child sleep, caregiver distress, and diabetes device use may influence neurocognitive development.

Conclusions:

  • Glycemic control, particularly avoiding DKA at diagnosis, is vital for neurocognitive health in T1D.
  • Factors like sleep and caregiver well-being play a role.
  • Future research should focus on mitigating risks and enhancing protective strategies in this population.
Abstract

Keywords:
ChildCognitionNeuroimagingType 1 diabetes

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