Tight control of blood sugar in teens may help reduce diabetes-related brain damage


Tight management of blood sugar in teenagers with Sort 1 diabetes could assist scale back the illness’s damaging results on the mind, results which have been proven even in youthful youngsters, in response to a research revealed on-line at the moment in Nature Communications. The findings point out that higher glucose management can really enhance mind construction and performance in youth with Sort 1 diabetes, bringing them nearer to their friends with out diabetes, investigators stated.

This proof-of-concept pilot research – essentially the most detailed up to now on this matter – was collectively led by investigators from Nemours Youngsters’s Well being, Jacksonville and Stanford College Faculty of Drugs.

These outcomes supply hope that hurt to the creating mind from Sort 1 diabetes is perhaps reversible with rigorous glucose management. Use of an automatic hybrid closed-loop system–an insulin supply system linked to a steady glucose monitor–was related to higher blood glucose concentrations, which translated in our research to quantifiable variations in mind construction and cognition.”

Nelly Mauras, MD, paper’s senior creator, and co-principal investigator, pediatric endocrinologist, Nemours Youngsters’s Well being Jacksonville and professor of pediatrics at Mayo Clinic School of Drugs

The research was carried out by means of the five-center Diabetes Analysis in Youngsters Community (DirecNet). Funded by the Nationwide Institutes of Well being (NIH), DirecNet has longitudinally adopted a cohort of kids with and with out diabetes for almost eight years. DirecNet research have added to proof that youngsters and youths with diabetes endure detrimental adjustments within the mind – with results together with below-normal IQ – and that these variations are linked to excessive blood sugars.

Dr. Mauras and the DirecNet investigators recruited 42 adolescents, aged 14 to 17 years, recognized with Sort 1 diabetes earlier than the age of eight who have been receiving insulin remedy. The teenagers have been randomized to certainly one of two teams – one utilizing a hybrid closed-loop insulin supply system and the opposite receiving commonplace diabetes care. The researchers carried out cognitive assessments and multi-modal mind imaging with all members earlier than and after the six-month research interval.

A hybrid closed-loop insulin supply system, used correctly and repeatedly, can enhance the period of time when blood sugar is in a wholesome vary. It significantly helps stabilize blood sugar throughout sleep, when detection and therapy of early indicators of hypoglycemia are tougher. The system makes use of a closed glucose monitor (CGM) to measure blood sugar each 5 minutes by means of a sensor underneath the pores and skin. The CGM connects wirelessly to an insulin pump that adjusts the quantity of insulin based mostly on the newest CGM studying.

Contributors utilizing the closed-loop glucose management system confirmed considerably larger enchancment than the usual care group in key mind metrics indicative of regular adolescent mind growth – in different phrases, their outcomes have been nearer to these of teenagers with out diabetes. The closed-loop group additionally confirmed larger cognitive (IQ) outcomes and practical mind exercise, extra in step with regular adolescent mind growth.

“We now have identified for a while that higher management of blood glucose ranges in individuals with Sort 1 diabetes can stop or scale back harm to numerous organic techniques (for instance, kidney, eyes, nerves, blood vessels). Our new analysis joins with different research to focus on that higher management of blood glucose ranges in youngsters with Sort 1 diabetes can doubtlessly scale back damage to the maturing mind and result in measurable enhancements in mind growth and performance as nicely,” stated lead creator and co-principal investigator, Allan Reiss, MD, the Howard C. Robbins Professor of Psychiatry and Behavioral Sciences and a professor of radiology at Stanford.

Sort 1 diabetes is an autoimmune illness, during which the physique’s immune system mistakenly destroys insulin-producing cells within the pancreas. Its causes will not be absolutely understood, and presently no remedy exists. An estimated 244,000 youngsters and adolescents within the U.S. have this situation, which may trigger typically severe well being issues that develop rapidly or that present up later in life. This research builds on earlier analysis displaying that strict blood sugar management results in decrease charges of diabetes issues similar to blindness, kidney failure, and amputations.


Journal reference:

Reiss, A.L., et al. (2022) A Pilot randomized trial to look at results of a hybrid closed-loop insulin supply system on neurodevelopmental and cognitive outcomes in adolescents with kind 1 diabetes. Nature Communications. doi.org/10.1038/s41467-022-32289-x.

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