Alterations in white matter structure in young children with type 1 diabetes

TitleAlterations in white matter structure in young children with type 1 diabetes
Publication TypeJournal Article
Year of Publication2014
AuthorsBarnea-Goraly, N., Raman M., Mazaika P., Marzelli M., Hershey T., Weinzimer S. A., Aye T., Buckingham B., Mauras N., White N. H., Fox L. A., Tansey M., Beck R. W., Ruedy K. J., Kollman C., Cheng P., & Reiss A. L.
Corporate AuthorsDiabetes Research in Children Network(DirecNet)
JournalDiabetes Care
Volume37
Issue2
Pagination332-40
Date Published2014 Feb
ISSN1935-5548
KeywordsBlood Glucose; Case-Control Studies; Child; Child, Preschool; Diabetes Mellitus, Type 1; Diffusion Magnetic Resonance Imaging; Female; Hemoglobin A, Glycosylated; Humans; Male; White Matter
Abstract

OBJECTIVE: To investigate whether type 1 diabetes affects white matter (WM) structure in a large sample of young children.
RESEARCH DESIGN AND METHODS: Children (ages 4 to <10 years) with type 1 diabetes (n = 127) and age-matched nondiabetic control subjects (n = 67) had diffusion weighted magnetic resonance imaging scans in this multisite neuroimaging study. Participants with type 1 diabetes were assessed for HbA1c history and lifetime adverse events, and glucose levels were monitored using a continuous glucose monitor (CGM) device and standardized measures of cognition.
RESULTS: Between-group analysis showed that children with type 1 diabetes had significantly reduced axial diffusivity (AD) in widespread brain regions compared with control subjects. Within the type 1 diabetes group, earlier onset of diabetes was associated with increased radial diffusivity (RD) and longer duration was associated with reduced AD, reduced RD, and increased fractional anisotropy (FA). In addition, HbA1c values were significantly negatively associated with FA values and were positively associated with RD values in widespread brain regions. Significant associations of AD, RD, and FA were found for CGM measures of hyperglycemia and glucose variability but not for hypoglycemia. Finally, we observed a significant association between WM structure and cognitive ability in children with type 1 diabetes but not in control subjects.
CONCLUSIONS: These results suggest vulnerability of the developing brain in young children to effects of type 1 diabetes associated with chronic hyperglycemia and glucose variability.




DOI10.2337/dc13-1388
Alternate JournalDiabetes Care
Refereed DesignationRefereed