(04-02-16) Variations in brain volume and growth in young children with type 1 diabetes.

Mazaika PK1, Weinzimer SA2, Mauras N3, Buckingham B4, White NH4, Tsalikian E5, Hershey T6, Cato A7, Aye T4, Fox L3, Wilson DM4, Tansey M5, Tamborlane W2, Peng D8, Raman M8, Marzelli M9, Reiss AL10; Diabetes Research in Children Network.
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Abstract
Early-onset type 1 diabetes may affect the developing brain during a critical window of rapid brain maturation. Structural magnetic resonance imaging was performed on 141 children with diabetes (ages 4-10 years at study entry) and 69 age-matched controls at two time points spaced 18 months apart. For the children with diabetes, HbA1c was 7.9±0.9% (63±9.8 mmol/mol)(mean±SD) at both time points. Relative to controls, children with diabetes had significantly less growth of cortical gray matter volume and cortical surface area, and significantly less growth of white matter volume throughout the cortex and cerebellum. For the diabetic population, the change across longitudinal time points of the blood glucose level at the time of scan was negatively correlated with the change in gray and white matter volumes, suggesting that fluctuating glucose levels in children with diabetes may be associated with corresponding fluctuations in brain volume. In addition, measures of hyperglycemia and glycemic variation were significantly negatively correlated with development of surface curvature. These results demonstrate that early-onset type 1 diabetes has widespread effects on the growth of gray and white matter for children whose blood glucose levels are well within the current treatment guidelines for management of diabetes.

Source: Diabetes. 2015 Oct 28. pii: db151242. [Epub ahead of print]

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