With the growing prevalence of childhood obesity, the incidence of type 2 diabetes in children and adolescents is increasing at an alarming rate. Type 2 diabetes may become the most common form of paediatric diabetes within the next decade. Older adults with type 2 diabetes are at increased risk for developing micro- and macrovascular complications, they also show significant cognitive slowing as well as learning and memory deficits.
Structural brain abnormalities are also commonly associated with type 2 diabetes among older adults, therefore, it is hypothesized that adolescents’ with type 2 diabetes may also suffer brain changes. Now, a study from researchers at Cincinnati Children’s Hospital shows that teenagers with type 2 diabetes have significant changes in total brain gray matter volume and in regions of gray matter involved in seeing and hearing, memory, emotions, speech, decision making, and self-control. The team state that their findings also show a relationship between less gray matter volume in the brain and the ability to pronounce and sound out unfamiliar words. The study was presented at the American Diabetes Association’s Scientific Sessions.
Previous studies show that there have been only a few brain studies in children and young adults with type 1 diabetes, and the findings are so far inconsistent. Structural brain abnormalities have been associated with type 2 diabetes among older adults and for the most part, those abnormalities tend to reflect non-specific pathology such as increased atrophy, overt white matter pathology or stroke, their magnitude being modest. More recent studies have demonstrated significantly reduced hippocampal volumes among middle-aged and elderly individuals with type 2 diabetes. However, no studies have used neuroimaging to evaluate cognition or brain changes in teenagers with type 2 diabetes. The current study uses MRI to show that teenagers with type 2 diabetes have changes in brain structure and poorer cognitive function scores compared to their peers.
The current study observed 20 teenagers with type 2 diabetes and compared them to 20 teens without type 2 diabetes who were similar in age, race and sex. All participants in the study had high-resolution MRIs and neither group had prior neurological or psychiatric disease or prior abnormal MRIs. Results show that these teenagers have six regions with significantly less gray matter, and three with significantly more.
The lab note that they are unsure if the changes found are the direct result of diabetes, however, studies in adults with type 2 diabetes with longer duration of disease also show brain volume differences, brain vascular changes and cognitive decline. The go on to state that, to their knowledge, total and regional brain volume had not been assessed comprehensively until now.
The team surmise that they have successfully imaged distinct gray matter changes in the brains of teenagers with type 2 diabetes. For the future, the researchers state that they are considering another study adding participants who are obese without type 2 diabetes and a larger number of participants. They go on to add that this would allow them to examine whether differences found on MRI are more related to obesity or high blood sugar seen in diabetes and test whether other cognitive domains, such as memory, language, intellect and attention, are affected by brain volume differences.