Why Do Some Teens With T1DM Navigate Slower?

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Adolescents with type 1 diabetes mellitus (T1DM) are at increased risk of impaired cognitive function, particularly in domains involving memory, attention, and executive functioning. Spatial navigation represents one such domain that may be influenced by metabolic and body composition factors. In an observational study published in Diabetes/Metabolism Research and Reviews, associations between body composition components and spatial navigation were evaluated in adolescents with T1DM.

The study included 64 adolescents (39 boys; mean age 15.9 ± 2.2 years). Spatial navigation was assessed using the Virtual Morris Water Maze Task (vMWMT), with outcomes including time-to-first move, time-to-platform, and path length. Body composition was measured by bioelectrical impedance analysis, including body mass index (BMI) and muscle-to-fat ratio (MFR) z-scores. Glycemic control was evaluated using glycated hemoglobin (HbA1c) and continuous glucose monitoring metrics. Sex-stratified correlation and multivariable linear regression models were applied.

BMI z-scores did not differ between sexes, whereas girls had lower MFR z-scores than boys. In boys, longer navigation times were correlated with lower MFR z-scores and glycemic measures, and regression models identified diabetes duration and MFR as predictors of navigation performance. In girls, higher BMI z-scores and HbA1c at diabetes onset were associated with navigation measures.

In this observational cohort, spatial navigation performance in adolescents with T1DM showed sex-specific associations with body composition and glycemic measures. MFR and diabetes duration were associated with navigation measures in boys, whereas body mass index z-score and HbA1c at diabetes onset were associated with navigation measures in girls.

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Key highlights

The study included 64 adolescents with T1DM (39 boys; mean age 15.9 ± 2.2 years).
Girls had lower MFR z-scores than boys (−0.60 ± 0.84 vs 0.25 ± 1.00; p < 0.001), while BMI z-scores did not differ by sex.
In boys, longer time-to-first move and time-to-platform were correlated with lower MFR z-scores, higher HbA1c, greater time in marked hypoglycemia and severe hyperglycemia, and longer diabetes duration.
In boys, diabetes duration predicted time-to-first move (B = 0.064; p = 0.009), and both diabetes duration and lower MFR predicted time-to-platform (R² = 0.457; p < 0.001).
In girls, time-to-platform correlated with higher BMI z-scores; HbA1c at diabetes onset predicted time-to-first move (B = −3.46; p = 0.018), and BMI z-score predicted time-to-platform (B = 9.33; p = 0.022).

Source

Zaitoon H, Perl L, Cohen-Sela E, Oren A, Lebenthal Y, Brener A. Sex differences in the association between body composition and cognitive performance in adolescents with type 1 diabetes. Diabetes Metab Res Rev. Published February 21, 2026. doi:10.1002/dmrr.70141

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