"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, Chief, Division of Endocrinology, Diabetes & Metabolism at Nemours Children's Clinic in Jacksonville, and lead author of the study.
Mauras and colleagues across the Diabetes Research in Children Network (DirecNet) of five clinical pediatric diabetes centers and a coordinating center, studied brain development in children ages four to nine years old with type 1 diabetes (T1D).
They used 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 T1D 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 T1D 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.
"Despite the best efforts of parents and diabetes care team, about 50 per cent of all blood glucose concentrations during the study were measured in the high range," said Mauras.
"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," said Mauras.

The study is published in the journal Diabetes.

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