February 6, 2014

White Matter Matters in T1D Kids


white-matterKids who have T1D have a little more to think about than the average kid. Can T1D impart any changes in the brain? A study published in Diabetes Care investigated whether a certain structure in the brain of kids with T1D is affected.

The portion of the brain studied in this research was the white matter. For all people, white matter affects how the brain learns and functions. The action observed is the efficacy of diffusion or transfer of nutrients and information.

Researchers evaluated children with T1D, ages 4 to 10 years old. The study looked at HbA1c, neurological testing, adverse events throughout the lifetime, and each participant wore a CGM.

Kids with T1D had significantly reduced axial diffusivity (AD) in the brain compared with control subjects. Kids who had earlier onset of T1D exhibited increased radial diffusivity (RD) and longer duration was associated with reduced AD, reduced RD, and increased fractional anisotropy (FA).

FA or fractional anisotrophy is a way to estimate efficiency and blood flow in the brain. AD and RD are elements in the equation specifying different regions of the brain.

When the CGM measured higher and more volatile glucose in T1D kid, the AD and RD factors were affected adversely. However this was not observed with low sugar.

At the end of the study, researchers observed a significant association between white matter vulnerability and cognitive ability in children with T1D. The elephant in the room is the uninvited guest to the party, chronic higher blood sugar and glucose variability.

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