Young children with type 1 diabetes have slower brain growth compared to children without diabetes, finds a new study in Diabetes.

The authors suggest that continued exposure to hyperglycemia, or high blood sugars, may be detrimental to the developing brain. They studied brain development in children ages four to nine years old with
type 1 diabetes
using structural magnetic resonance imaging (MRI) and cognitive tests to determine if abnormal blood glucose levels impact brain structure and function at a young age. Children with
type 1 diabetes
also underwent blood sugar monitoring using continuous glucose sensors. 

The researchers found that the brains of children with diabetes showed slower overall and regional growth of gray and white matter compared to children without diabetes. These changes were associated with higher and more variable blood sugar levels. Although there were no significant differences in cognitive function between groups at 18-months, the brain imaging results suggest that the children with
type 1 diabetes
had differences in brain maturation compared to children without diabetes. Some of the brain regions impacted are involved in visual-spatial processing, executive functions and working memory.

 "Our results show the potential vulnerability of young developing brains to abnormally elevated glucose levels, even when the diabetes duration has been relatively brief," said Nelly Mauras, MD, Chief, Division of Endocrinology, Diabetes&Metabolism at Nemours Children's Clinic in Jacksonville, Fla., and lead author of the study. "Despite the best efforts of parents and diabetes care team, about 50 percent of all blood glucose concentrations during the study were measured in the high range. Remarkably, the cognitive tests remained normal, but whether these observed changes will ultimately impact brain function will need further study. As better technology develops, we hope to determine if the differences observed with brain imaging can improve with better glucose control" 

"This is the thing that parents always worry about when it comes to a child with a chronic illness," study co-author Karen Winer, MD, pediatric endocrinologist at the National Institutes of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development, said in the press release. "Does it affect their brain? The good news here is that there may be some viable solutions on the horizon that parents should be aware of."