In people with diabetes, having elevated blood glucose levels is well known to cause a variety of long-term complications. But a new study suggests that high glucose can have adverse effects as early as childhood in one important area of the body: your brain.
Presented earlier this month at the American Diabetes Association’s 79th Scientific Sessions in San Francisco, the study used magnetic resonance imaging (MRI) to map white and gray matter in areas of the brain that are important to cognitive performance. Participants included 138 children with type 1 diabetes for an average duration of 2.4 years, as well as 66 children without diabetes — all with an average age of about 7 years at the study’s start.
MRIs were performed initially, 18 months later, and then about 3 years after the second MRI. The researchers also calculated a lifetime HbA1c (a measure of long-term blood glucose control) score — from their diabetes diagnosis to the study’s beginning — for the type 1 group.
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The researchers found that at all three points in time when MRIs were performed, the diabetes group had slower growth of white and gray matter in the assessed areas of the brain. There was also less growth, in particular, in a set of brain regions known as the “default mode network,” which are associated with other brain disorders. A higher lifetime HbA1c level was associated with less growth in these regions.
Among all children in the study, there was a large degree of variability in growth of the measured brain areas — suggesting that numerous factors other than diabetes or blood glucose contribute to brain development and cognitive performance. Still, the relationship between brain growth and both diabetes and HbA1c levels was clear.
Despite advanced in diabetes technology, “children with diabetes are still exposed to significant hyperglycemia and hypoglycemia, which will continue to confer a risk to the brain,” says the study’s co-principal investigator, Nelly Mauras, MD, chief of the division of endocrinology, diabetes & metabolism at the Nemours Children’s Health System in Jacksonville, Florida.
”Understanding these early effects is a necessary step towards understanding effects later in adulthood, and in developing strategies for reducing risk of brain-associated complications” of diabetes, says Mauras — including looking at whether maintaining near-normal blood glucose levels can dramatically reduce this risk.
Want to learn more about caring for kids with type 1 diabetes? Read “The Type 1 Diabetes Diagnosis,” “Type 1 Diabetes and Sleepovers or Field Trips,” “Writing a Section 504 Plan for Diabetes,” and “Top 10 Tips for Better Blood Glucose Control.”
A freelance health writer and editor based in Wisconsin, Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy.