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SAN FRANCISCO, June 9, 2019 / PRNewswire / – Children with early type 1 diabetes (T1D) and poor glycemic control have slower growth in brain areas badociated with mild cognitive deficits compared to non-diabetic children, according to the study , "ADA Presidents' Select Abstract: Type 1 Diabetes and Brain Development – A Longitudinal Study of Brain Growth Performed by the Childhood Diabetes Research Network (DirecNet)", Presented today at the American Diabetes Association® (79th Scientific Sessions of the ADA)® at the Moscone Convention Center San Francisco. The study found that children with early-onset T1D had slight but significant differences in total brain growth and regional and regional gray matter compared to non-diabetic children.
Over time, T1D can lead to complications in many organ systems, including retina, cardiovascular disease, kidney and peripheral nervous system. Research also suggests that glycemic fluctuations in hypoglycemia and hyperglycemia badociated with T1D can negatively affect brain development. Despite improved glycemic control due to emerging technologies and new insulins, there is growing evidence that people with T1D are at risk for cognitive dysfunction.
As part of a multi-site study of the Diabetes Research Network in Children (DirecNet), researchers sought to determine how much glycemic exposure has a negative impact on brain development in children with T1D at early onset. The study recruited 138 children with T1D with a median age of seven years. Participants had an average disease duration of 2.4 years at baseline. The researchers conducted structural magnetic resonance imaging (MRI) studies on the brains of participants and compared the results to those of a control group comprising 66 age-matched children (mean age). Age of seven) without diabetes.
The MRIs were performed at three different times (baseline, 18 months and about 2.9 years after the second visit), and then the white matter and gray matter volumes in various areas of brain interest were determined. Total cumulative hyperglycemic exposure was determined (HbA1c in the course of life) from the time of diagnosis in the DT1 group.
The researchers found that the group with T1D had a slower growth in GM and total cortical and subcortical MW than the control group at all times. A set of metabolically active brain regions that form the "default mode network", badociated with other brain disorders, showed lower growth in the DT1 group compared to the control group. These slower growing regions were badociated with higher HbA1c values over the course of life.
"With an ever increasing number of people living to old age, cognitive dysfunctions badociated with diabetes could have adverse consequences for public health," said Nelly Mauras, MD, principal investigator and head of the endocrinology division , diabetes and metabolism in the infant health system of Nemours in Jacksonville, Floridaand professor of pediatrics at Mayo College of Medicine. "While new advances in insulin and technologies can dramatically improve care, children with diabetes are still exposed to significant hyperglycemia and hypoglycemia, which will continue to pose a risk to the brain. young children with type 1 diabetes There were significant differences in brain structure and growth compared to the control group, and poor glycemic control may increase the risk of changes in brain structure over time. the variability in the results remains unexplained, therefore understanding these early effects is a necessary step toward understanding later in adulthood and developing strategies to reduce the risk of brain complications of type diabetes. 1. There is some debate as to whether maintaining scrupulous quasi-normoglycemia with advanced diabetes technologies will have a positive impact on these results. "
Speak with Dr. Mauras or Dr. Allan Reiss, Co-Principal Investigators, please contact the ADA Press Office on site at the Moscone Convention Center at June 7-11, by phone at 415-978-3606 or by email at [email protected].
The 79th Scientific Sessions of the American Diabetes Association, the World's Largest Scientific Meeting on Diabetes Research, Prevention and Care, Held June 7 to 11, 2019at the Moscone Center in San Francisco, California. Nearly 15,000 physicians, scientists, health professionals and industry representatives from around the world gathered at scientific sessions to present cutting-edge research, treatment recommendations and advances toward diabetes treatment . During this five-day meeting, attendees have exclusive access to more than 850 presentations and 2,000 original research presentations, engage in stimulating and stimulating discussions with leading diabetes experts, and earn continuing education credits. (FMC) or Continuing Education (CE) for educational sessions. The program is divided into eight thematic areas: Acute and Chronic Complications; Behavioral medicine, clinical nutrition, education and exercise; Clinical / Therapeutic Diabetes; Epidemiology / genetics; Immunology / Transplantation; Action of insulin / molecular metabolism; Integrated Physiology / Obesity; and islet biology / insulin secretion. Gretchen Youssef, MS, RDN, CDE, chair of health care and education, delivered his speech titled "It's all about access!", The Saturday, June 8, and Louis H. Philipson, MD, PhD, FACP, President of Medicine and Science, will give his lecture entitled "Precision Medicine – Addressing the Multiple Facets of Diabetes", the Sunday, June 9. Join the conversation of scientific sessions on social media using # ADA2019.
About the American Diabetes Association
Every day, more than 4,000 people are diagnosed with diabetes in America. Nearly 115 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the country's leading volunteer health organization that fights to counter the diabetes epidemic and help people living with diabetes to flourish. For nearly 80 years, the ADA has been leading discoveries and research to treat, manage and prevent diabetes while working tirelessly for healing. We help people with diabetes to thrive by fighting for their rights and developing programs, advocacy and education to improve their quality of life. Diabetes has brought us together. What we do next will make us connected for life. For more information or to get involved, visit our website at diabete.org or call 1-800-DIABETES (1-800-342-2383). The information is available in English and Spanish. Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).
209-OR Type 1 Diabetes and Brain Development – A Longitudinal Study of Brain Growth by the Diabetes Research Network for Children (DirecNet)
79th Scientific Session
Briefing: Changing concepts in type 1 diabetes, Sunday, June 9, 12:00 – 13:00
Session type: oral presentations
Session Title: From Risk to Complications of Type 1 Diabetes in Youth – What's New? (With abstract presentation chosen by the presidents of the ADA)
Location: S-10 (south, exposure level)
Session time: Sunday, June 9, 2019, 16:30 – 18:30
ANA MARIA ARBELAEZ, STEFANI O & # 39; DONOGHUE, NELLY MAURAS, BRUCE A. BUCKINGHAM, NEIL H. WHITE, STUART A. WEINZIMER, TANDY AYE, EVA TSALIKIAN, DARRELL M. WILSON, WILLIAM V. TAMBORLANE, MICHAEL TANSEY, ALLISON CATO, TAMARA HERSHEY, LARRY A. FOX, KIMBERLY A. ENGLERTALLAN L. REISS, Saint Louis, MO, Stanford, California, Jacksonville, FL, Palo Alto, California, New Haven, CT, Iowa City, IA
Context: The extent to which glycemic exposure has a negative impact on brain development in young children with early type 1 diabetes (T1D) is controversial.
The methods: In the DirecNet multisite study, we performed a structural MRI at three different times (baseline, 18 months and approximately 2.9 years after the second visit) in 137 children with T1D (age: 7.0 ± 1 , 7 years, mean lifetime HbA1c: 8.0 ± 0.7% and duration of diabetes: 2.4 years at the start of the study) and 66 age-matched non-diabetic controls (7.0 at 1.8 years). The volumes of white matter (MW) and gray matter (GM) in different areas of brain interest were determined by voxel-based morphometry (VBM). Total cumulative hyperglycemic exposure was determined as the HbA1c area under the curve (A1c lifetime) from the time of diagnosis in children with T1D.
Results: Children with T1D had a slower growth in total cortical and subcortical GM and MW than non-diabetic controls at all time points. The gray matter regions (frontal, temporal, subcortical, and occipital cortex) showed lower growth in T1D compared to the control group (p <0.05 corrected by a family confusion error (FWE)). than the white matter zones (temporal, parietal and occipital white matter) (p <0.05 FWE corrected). The occipital-cerebellar and basal ganglionic regions appear to be the most vulnerable to the effects of T1D in children. Slower growing regions were badociated with higher values of A1c over the course of life (p <0.05 corrected for false detection rate (FDR)).
Conclusion: This study demonstrates that children with early-onset T1D who have low glycemic control have a slower growth of GMOs and cortical and subcortical MW than non-diabetic controls, suggesting that Hyperglycemia impairs brain development during this critical period of rapid brain maturation. The long-term consequences of these early alterations in brain growth require additional follow-up.
Disclosure block of the author: A.Arbelaez: No. W.V.Tamborlane: Consultant; self; AstraZeneca, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Medtronic MiniMed, Inc., Novo Nordisk Inc., Sanofi, Takeda Pharmaceutical Company Limited. M.Tansey: Consultative Committee; self; Daiichi Sankyo Company, Limited. A.Cato: No. T.Hershey: Support for research Spouse / partner; Sage Pharmaceuticals. L.A.Fox: No. K.A.Englert: Consultant; self; PicoLife Technologies, LLC. A.L. Reiss: No. S. O & # 39; Donoghue: No. N.Mauras: Consultant; self; Novo Nordisk Inc., PicoLife, Research Support; self; Medtronic MiniMed, Inc. B.A.Buckingham: Consultative Committee; self; ConvaTec Inc., Novo Nordisk Inc., Profusa, Inc., Consultant; self; Medtronic MiniMed, Inc., Other relationship; self; Insulet Corporation, Tandem Diabetes Care, Research Support; self; Beta Bionics, ConvaTec Inc., Dexcom, Inc., Insulet Corporation, Medtronic MiniMed, Inc., Tandem Diabetes Care. N.H.White: No. S.A.Weinzimer: Consultant; self; Eli Lilly and Company, Sanofi, Zealand Pharma A / S, consultant; Spouse / partner; Tandem Diabetes Care, Speaker's Office; self; Insulet Corporation, Medtronic MiniMed, Inc., Tandem Diabetes Care, Action / Shareholder; self; InsuLine Medical Ltd. T.Aye: No. E.Tsalikian: No. D. M. Wilson: Consultative Committee; self; Tolerion, Inc., Research Support; self; Beta Bionics, Dexcom, Inc., Medtronic.
Contact:
Michelle Kirkwood
(703) 299-2053
[email protected]
SOURCE American Diabetes Association
Related Links
http://www.diabetes.org
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