Objective: The overarching hypothesis explored in this research was discerning the relations between the neuro-cognitive accomplishments of adolescents with T1D patients and healthy siblings of similar age, according to the transient glucose excursions, and the quantitative parameters of white matter in specific pathways according to glycaemic control.
Research Design and Methods: A case-control study included 12-18 years old patients with T1D (n=17, 8 males, diabetes duration of 6.53±4.1 year) and their healthy siblings (n=13). Participants underwent brain imaging, including diffusion tension imaging (DTI) and baseline neurocognitive tests. All were hospitalized for 30 hours for continuous glucose monitoring and multiple repeated neurocognitive tests as a function of controlled manipulation of food intake and pre-meal insulin administration to enable capillary glucose of above 240 mg/dl vs lower than 180 mg/dl.
Results: T1D patients' mean HbA1c was 8.61±1.26, 8 of them having HbA1c≤8.3. Significant associations were detected between glucose level, HbA1c, and executive function (EF), inhibition ability, and semantic and episodic memory. White matter analysis demonstrated opposite effects of diffusion coefficients in various regions according to glycaemic control, indicating specific associations between anatomical pathways and cognitive performance as a function of the group, with novel association to food stimuli.
Conclusions: Worse glycaemic control and transient high glucose levels are associated with lower executive function performance and variability in brain architecture in related areas.
15 Sep 2022 - 17 Sep 2022