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Diabetes. 2016 Feb;65(2):476-85. doi: 10.2337/db15-1242. Epub 2015 Oct 28.

Variations in Brain Volume and Growth in Young Children With Type 1 Diabetes.

Author information

1
Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA mazaika@stanford.edu.
2
Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
3
Department of Pediatrics, Division of Endocrinology, Diabetes and Metabolism, Nemours Children's Health System, Jacksonville, FL.
4
Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
5
Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO.
6
Department of Pediatric Endocrinology, The University of Iowa, Iowa City, IA.
7
Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO Department of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO.
8
Division of Neurology, Nemours Children's Health System, Jacksonville, FL.
9
Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.
10
Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA Department of Bioengineering, Stanford University School of Medicine, Stanford, CA Department of Radiology, Stanford University School of Medicine, Stanford, CA.
11
Center for Interdisciplinary Brain Sciences Research, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA Department of Pediatrics, Stanford University School of Medicine, Stanford, CA Department of Radiology, Stanford University School of Medicine, Stanford, CA.

Abstract

Early-onset type 1 diabetes may affect the developing brain during a critical window of rapid brain maturation. Structural MRI was performed on 141 children with diabetes (4-10 years of age at study entry) and 69 age-matched control subjects at two time points spaced 18 months apart. For the children with diabetes, the mean (±SD) HbA1c level was 7.9 ± 0.9% (63 ± 9.8 mmol/mol) at both time points. Relative to control subjects, 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 population with diabetes, the change in the blood glucose level at the time of scan across longitudinal time points 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 the development of surface curvature. These results demonstrate that early-onset type 1 diabetes has widespread effects on the growth of gray and white matter in children whose blood glucose levels are well within the current treatment guidelines for the management of diabetes.

PMID:
26512024
PMCID:
PMC4747456
DOI:
10.2337/db15-1242
[Indexed for MEDLINE]
Free PMC Article
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