Persistence of abnormalities in white matter in children with type 1 diabetes

TitlePersistence of abnormalities in white matter in children with type 1 diabetes
Publication TypeJournal Article
Year of Publication2018
AuthorsFox, L. A., Hershey T., Mauras N., Arbeláez A. M., Tamborlane W. V., Buckingham B., Tsalikian E., Englert K., Raman M., Jo B., Shen H., Reiss A., & Mazaika P.
Corporate AuthorsDiabetes Research in Children Network(DirecNet)
JournalDiabetologia
Volume61
Issue7
Pagination1538-1547
Date Published2018 Jul
ISSN1432-0428
KeywordsBrain development; Paediatric diabetes; White Matter
Abstract

AIMS/HYPOTHESIS: Prior studies suggest white matter growth is reduced and white matter microstructure is altered in the brains of young children with type 1 diabetes when compared with brains of non-diabetic children, due in part to adverse effects of hyperglycaemia. This longitudinal observational study examines whether dysglycaemia alters the developmental trajectory of white matter microstructure over time in young children with type 1 diabetes.
METHODS: One hundred and eighteen children, aged 4 to <10 years old with type 1 diabetes and 58 age-matched, non-diabetic children were studied at baseline and 18 months, at five Diabetes Research in Children Network clinical centres. We analysed longitudinal trajectories of white matter using diffusion tensor imaging. Continuous glucose monitoring profiles and HbA levels were obtained every 3 months.
RESULTS: Axial diffusivity was lower in children with diabetes at baseline (p = 0.022) and at 18 months (p = 0.015), indicating that differences in white matter microstructure persist over time in children with diabetes. Within the diabetes group, lower exposure to hyperglycaemia, averaged over the time since diagnosis, was associated with higher fractional anisotropy (p = 0.037). Fractional anisotropy was positively correlated with performance (p < 0.002) and full-scale IQ (p < 0.02).
CONCLUSIONS/INTERPRETATION: These results suggest that hyperglycaemia is associated with altered white matter development, which may contribute to the mild cognitive deficits in this population.




DOI10.1017/S1355617709090468
Alternate JournalDiabetologia
Refereed DesignationRefereed