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Neurocognitive Outcomes of Type 1 Diabetes in Children

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  1. Introduction to type 1 diabetes mellitus
    1. What is diabetes Mellitus?
    2. Prevalence and demographics
    3. Neural basis of T1DMa
    4. Treatment
  2. Cognitive outcomes on memory
    1. Neural basis of memory
    2. Cognitive outcome of T1DM on memory
  3. Structural changes in the brain as a result of T1DM: MRI studies
    1. Hippocampus
    2. Effect of T1DM on other brain areas

Type 1 Diabetes Mellitus (T1DM) is a disease caused by the inability of the body to produce insulin. As a result of the human defenses against autoimmune disorders, insulin producing cells in the body are identified as foreign and therefore targeted by immune cells for destruction. Insulin is a hormone produced by the pancreas, which is responsible for regulating blood glucose levels through the regulation of glucose uptake from blood into storage cells. High levels of blood glucose can result in damage of organs such as the kidney, liver, pancreas and brain. The main symptoms of diabetes include weight loss, polynuria and presence of sugar in urine. It is characteristic of T1DM for symptoms to develop quickly especially in young people.

[...] Cognitive function in children with type 1 diabetes a meta-analysis. Diabetes Care, 1892-1897. Ghetti, S., Lee, J. K., Sims, C. E., DeMaster, D. M., & Glaser, N. S. (2010). Diabetic ketoacidosis and memory dysfunction in children with type 1 diabetes. The Journal of pediatrics, 156(1), 109-114. Gispen, W. H., &Biessels, G. J. (2000).Cognition and synaptic plasticity in diabetes mellitus. Trends in neurosciences, 23(11), 542-549. Haces, M. L., Montiel, T., &Massieu, L. (2010).Selective vulnerability of brain regions to oxidative stress in a non-coma model of insulin- induced hypoglycemia. [...]

[...] To other patients, pancreas transplant is recommended. It involves the transfer of a full functional pancreas from a donor into a patient. This is a high risk operation that can only be performed in a few hospitals that have the required equipment and personnel. The challenge to this method being adopted is the availability of donors to provide the cadaver. I. Cognitive outcomes on memory 1. Neural basis of memory Ghetti, S., Lee, J. K., Sims, C. E., DeMaster, D. M., & Glaser, N. [...]

[...] A., Meyer, E., Rutlin, J., Perantie, D. C., White, N. H., Arbelaez, A. M., & Hershey, T. (2013). White matter microstructural integrity in youth with type 1 diabetes. Diabetes, 581- Purpose and function The hippocampus is a brain section that is responsible for consolidation of information in the brain. It is found in the right and left sides of the brain in the temporal lobe (Gispen and Biessels 2000). It is responsible for the conversion of information into permanent memory from short-term memory. [...]

[...] Neuroscience, 165(1), 28-38. Hershey, T., Lillie, R., Sadler, M., &White, N. H. (2003). Severe hypoglycemia and long-term spatial memory in children with type 1 diabetes mellitus: a retrospective study. Journal of the International Neuropsychological Society, 740-750. Hershey, T., Perantie, D. C., Wu, J., Weaver, P. M., Black, K. J., & White, N. H. (2010). Hippocampal volumes in youth with type 1 diabetes. Diabetes, 236-241. Jones, T. W., & Davis, E. A. (2003). [...]

[...] The condition affects 25 to 40 percent of patients with onset T1DM and is believed to cause brain injury. There are two possible causes of the altered diffusion in the T1DM patient's white matter, the first reason is the fact that there is rapid glucose restoration following hypoglycemia and a slower loss of solutes causing swelling of nerve cells(Ennis et al 2008). The second probable cause is the breakdown of the blood brain barrier which results in fluids moving from the blood into the white matter of the brain causing a brain water imbalance.(Dorsey et al 2013). [...]

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