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Brain risk with type 2 diabetes

dolescents with condition may have impaired cognitive function

Posted in Children and young people on 31st July, 2010 | no responses

Central nervous system abnormalities including cognitive and brain impairments have been documented in adults with type 2 diabetes who also have multiple co-morbid disorders. Based on this observation, Yau et al. assessed adolescents with type 2 diabetes to evaluate whether having this condition adversely affects brain function and structure years prior to the development of clinically significant vascular disease.

This hypothesis was evaluated by comparing 18 obese adolescents with type 2 diabetes and 18 obese controls without evidence of marked insulin resistance. The two groups were compatible on age, sex, school grade, ethnicity, socioeconomic status, BMI and waist measurement. The participants of the study then underwent MRI and neuropsychological evaluations. The results of the study revealed that the adolescents with type 2 diabetes performed worse in all cognitive areas that were evaluated, with the difference being statistically significant for estimated intellectual functioning, verbal memory and psychomotor efficiency. There were also statistical trends for reading and spelling. The MRI showed both reduced white matter volume and enlarged cerebrospinal fluid space in the whole brain and the frontal lobe in particular, but there was no obvious grey matter volume reduction.

This is the first study of its kind that reports possible brain abnormalities among obese adolescents with type 2 diabetes relative to the control group who come from similar backgrounds. Therefore the differences are not likely to result from education or socioeconomic bias but instead may result from subtle vascular changes, glucose and lipid metabolism abnormalities and subtle differences in adiposity in the absence of clinically significant vascular disease. This study highlights an additional dimension of the negative impact chronic disease has on health and particularly the potentially detrimental outcomes for young people before other complications develop.

Source: Diabetologia, 30 July 2010.

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