Brain MRI in Children With Type 1 Diabetes: Snapshot or Road Map of Developmental Changes?

  1. Yael D. Reijmer1,2
  1. 1Department of Neurology, Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands
  2. 2J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  1. Corresponding author: Geert Jan Biessels, g.j.biessels{at}umcutrecht.nl.

The impact of diabetes on the developing brain is a complex subject. From the perspective of children and parents, potential harm to the brain can be a frightening but elusive topic. Many factors can affect a child’s well-being and mental development. The challenge is to disentangle potential consequences of diabetes from all these other factors. For health care workers the topic may be no less elusive. There is quite an abundance of literature on the potential adverse effects of type 1 diabetes on the brain in children, but it is difficult to translate the available data into clinically meaningful information that can be applied to the day-to-day care for an individual child. In this issue, Marzelli et al. (1), on behalf of the Diabetes Research in Children Network, present an important study that answers several questions on the impact of diabetes on the developing brain, but also generates new ones.

It is well established that development of diabetes early in life can have consequences for cognitive functioning (2,3). Several studies have shown that—on average—children with diabetes perform worse on several cognitive domains than children without diabetes (4). Among children with diabetes, cognitive decrements are most marked for children with an early diabetes onset—usually defined as an onset within the first 4–7 years of life (2,4). These decrements tend to evolve slowly over time, mounting up …

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