Prevalence of Structural Central Nervous System Abnormalities in Early-Onset Type 1 Diabetes Mellitus

Objective To characterize the effects of severe hypoglycemia on the developing brain in children with early-onset type 1 diabetes mellitus (T1DM). Study design Children diagnosed with T1DM before age 6 years were studied. Those with prospectively monitored severe hypoglycemia (coma/seizure; n = 32)...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Journal of pediatrics 2008-09, Vol.153 (3), p.385-390
Hauptverfasser: Ho, Margaret S., BA (Hons), Weller, Narelle J., BappSc, Ives, F. Jay, MBChB, FRANZCR, Carne, Christine L., BSc, PGDip (Paediatrics), GradCert (Diab Educ), Murray, Katherine, BSc, PGDip HSc, GradDip (Diet), vanden Driesen, Rohan I., FRANZCR, Nguyen, Thai P., MBBS, FRANZCR, Robins, Peter D., MBBS, Bulsara, Max, MSc, Davis, Elizabeth A., FRACP, Jones, Timothy W., MD, FRACP
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Objective To characterize the effects of severe hypoglycemia on the developing brain in children with early-onset type 1 diabetes mellitus (T1DM). Study design Children diagnosed with T1DM before age 6 years were studied. Those with prospectively monitored severe hypoglycemia (coma/seizure; n = 32) were compared with age-matched peers (n = 30) with no history of such events using magnetic resonance imaging. Glycemic control (evaluated based on glycated hemoglobin [HbAlc ] level), episodes of diabetic ketoacidosis (DKA), and clinical variables were monitored continuously since diagnosis in all subjects. Results Mean HbAlc from diagnosis and the duration of T1DM were similar in those with and without a history of severe hypoglycemia (9.0% ± 0.9% vs 8.8% ± 0.9%; 7.2 ± 2.7 years vs 6.7 ± 2.3 years). A high prevalence of central nervous system (CNS) structural abnormalities was detected (29%), and mesial temporal sclerosis (MTS) was detected in 16% of the total sample (n = 62). The presence of MTS was not associated with a history of severe hypoglycemia or DKA. Analysis of brain matter volumes suggested relatively less gray matter density in those subjects with a history of severe hypoglycemia. Conclusions Early age of onset of T1DM per se is associated with a high incidence of CNS abnormalities, particularly MTS, suggesting hippocampal damage. Early-onset severe hypoglycemia may have an effect on gray matter volume.
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2008.03.005