January 7, 2013

Brain Injuries in T1D from DKA


T1D-brainUnder the influence of diabetic ketoacidosis, the body becomes dehydrated and the electrolyte balance is derranged. A study investigating the mechanism of cerebral injury in pediatric diabetic ketoacidosis is taking a closer look at just how damaging it can be in Type 1 diabetes.

The journey down the rabbit hole may explain why the treatment of a child in DKA affects the brain similar to a dry sponge absorbing a bucket of water. Furthermore, how can this reabsorption rate be controlled so that the brain doesn’t sustain injury as a result of the rescue from DKA?

DKA or diabetes ketoacidosis is a life-threatening condition of high glucose. Especially in children with Type 1 diabetes, the treatment of DKA requires replenishment of fluids and electrolytes to the body and can cause swelling in the brain. Until recently, researchers were not aware of the diabetes-related brain injury that may result in children who experience DKA.

The DKA-induced brain injuries in T1D are similar to those experienced by non-diabetic children who had brain injury resulting from reduced blood flow and reduced oxygen to the brain. The lack of this blood and oxygen supply to the brain also impacts the balance of the ion transporters. When the dehydrated state of a brain in DKA is rehydrated, the restoration of fluid and electrolytes may cause swelling that puts a child at risk of brain injury.

Based on prior experience while in residency, the lead researcher looked in medical literature for a reason why the risk of  brain injury was higher in pediatric diabetes patients. Dr. Glaser was met with little to no answers and so began her mission to understand and resolve this critical crisis. A goal of this research is to examine mechanisms of brain injury before, during, and after DKA, find a cause for DKA-related brain injury and protect it from happening.

The role of glucose and insulin in the brain is more significant than previously recognized. It’s sobering to acknowledge that the effects of insulin in the brain have been linked to degenerative diseases and injuries. The future study of insulin and glucose and how it affects the brain is a pioneering field in diabetes research.

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