New research in Diabetes suggests that type 1 diabetes can have long-lasting effects on brain development in children, particularly in the white matter. White matter is the part of the brain responsible for communication between regions. However, some of these differences reduce as children enter puberty.

In this long-term study, researchers followed 143 children with type 1 diabetes and 71 children without diabetes, all aged between 4 and 9 years at the start of the study. Over a period of 6 to 8 years, the children underwent brain MRI scans using diffusion tensor imaging (DTI), cognitive testing, and detailed glucose monitoring during four separate visits.

The MRI scans focused on several markers of white matter health. These markers include axial diffusivity (AD), radial diffusivity (RD), fractional anisotropy (FA), and mean diffusivity (MD).

Over time, children with and without diabetes showed brain maturation, with increasing FA and decreasing RD, AD, and MD. However, a key finding was that children with type 1 diabetes had significantly lower AD than those without diabetes during the ages of 6 to 10 years. This indicates delayed or disrupted development of white matter fiber integrity. This gap was not observed as strongly during puberty.

Children who spent more time with blood glucose levels in the target range had better brain imaging results, particularly higher FA values. Higher FA values suggest better fiber organization and myelination. These children also performed better on cognitive tests.