Alterations in White Matter Structure in Young Children With Type 1 Diabetes Featured Article: Naama Barnea-Goraly, Mira Raman, Paul Mazaika, Matthew Marzelli,

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Alterations in White Matter Structure in Young Children With Type 1 Diabetes Featured Article: Naama Barnea-Goraly, Mira Raman, Paul Mazaika, Matthew Marzelli, Tamara Hershey, Stuart A. Weinzimer, Tandy Aye, Bruce Buckingham, Nelly Mauras, Neil H. White, Larry A. Fox, Michael Tansey, Roy W. Beck, Katrina J. Ruedy, Craig Kollman, Peiyao Cheng, and Allan L. Reiss for theDiabetes Research in Children Network (DirecNet) Diabetes Care Volume 37: February, 2014

STUDY OBJECTIVE To investigate whether type 1 diabetes affects white matter (WM) structure in a large sample of young children Barnea-Goraly N. et al. Diabetes Care 2014;37:

STUDY DESIGN AND METHODS Children (ages 4 to <10 years) with type 1 diabetes and age- matched nondiabetic control subjects underwent diffusion- weighted magnetic resonance imaging scans Participants with type 1 diabetes were assessed for HbA1c history and lifetime adverse events Glucose levels were monitored using a continuous glucose monitor (CGM) device and standardized measures of cognition Barnea-Goraly N. et al. Diabetes Care 2014;37:

RESULTS Between-group analysis showed that children with type 1 diabetes had significantly reduced axial diffusivity (AD) in widespread brain regions compared with control subjects Earlier onset of diabetes was associated with increased radial diffusivity (RD), and longer duration was associated with reduced AD, reduced RD, and increased fractional anisotropy (FA) Barnea-Goraly N. et al. Diabetes Care 2014;37:

RESULTS HbA 1c values were negatively associated with FA values and were positively associated with RD values in widespread brain regions Significant associations of AD, RD, and FA were found for CGM measures of hyperglycemia and glucose variability but not for hypoglycemia A significant association was observed between WM structure and cognitive ability in children with type 1 diabetes but not in control subjects Barnea-Goraly N. et al. Diabetes Care 2014;37:

CONCLUSIONS The developing brain is vulnerable in young children to the effects of type 1 diabetes associated with chronic hyperglycemia and glucose variability Barnea-Goraly N. et al. Diabetes Care 2014;37: