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Glycemic Extremes Affect Brain Development in Type 1 Diabetes

Less whole brain gray matter in hyperglycemia; less occipital/parietal white matter in hypoglycemia

TUESDAY, Oct. 11 (HealthDay News) -- For patients with type 1 diabetes (T1DM), more exposure to hyperglycemia is associated with a decrease in whole brain gray matter, and severe hypoglycemia is associated with greater decreases in occipital/parietal white matter volume, according to a study published online Sept. 27 in Diabetes.

Dana C. Perantie, from the Washington University School of Medicine in St. Louis, and colleagues investigated the differential changes in brain regions depending on the degree of exposure to glycemic extremes in youth with T1DM, while their siblings without diabetes served as controls (NDC). Each participant underwent brain neuroimaging at baseline and two years later. During the two-year follow-up, blood glucose control measurements (HbA1c, glucose meter results, and reports of severe hypoglycemia) were recorded. Whole brain and voxel-wise statistical analyses of the changes in gray and white matter volume were assessed, after controlling for age, gender, and age of diabetes onset.

The investigators found no difference between the T1DM and NDC groups in whole brain or voxel-wise change over the two-year study period. Participants in the T1DM group with more hyperglycemia exhibited a significantly greater reduction in whole brain gray matter than those with less hyperglycemia. The occipital/parietal white matter volume decreased significantly more in participants who experienced severe hypoglycemia compared to those with no severe hypoglycemia, and compared to the NDC group.

"Within diabetes, exposure to hyperglycemia and severe hypoglycemia may result in subtle deviation from normal developmental trajectories of the brain," the authors write.

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