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Better Glucose Control in Youth With T1D Might Prevent Brain Changes

More improvement seen in certain indicators of neurotypical development at six months among adolescents using hybrid closed-loop system

WEDNESDAY, Sept. 7, 2022 (HealthDay News) — A hybrid closed-loop insulin delivery system might prevent or reverse some alterations to the developing brain in adolescents with type 1 diabetes (T1D), according to a study published online Aug. 30 in Nature Communications.

Allan L. Reiss, M.D., from Stanford University in California, and colleagues examined whether magnetic resonance imaging-derived indices of brain development and function and standardized IQ scores in adolescents with T1D (aged 14 to 17 years) could be improved with better diabetes control using a hybrid closed-loop insulin delivery system. Forty-four participants were randomly assigned to a hybrid closed-loop or standard diabetes care group; two were excluded from the final analysis. Before and after the six-month study duration, 42 adolescents underwent cognitive assessment and multimodal brain imaging.

The researchers found significantly greater improvement in several primary outcomes indicative of neurotypical development during adolescence, including cortical surface area, regional gray volumes, and fractional anisotropy, for participants in the hybrid closed-loop group versus the standard care group. No significant between-group differences were seen in total gray and white matter volumes or cortical thickness. Higher Perceptual Reasoning Index IQ scores and functional brain activity more indicative of neurotypical development were seen in the hybrid closed-loop group versus the standard care group. There were no adverse effects associated with study participation.

“This study gives hope that, with significantly improved glucose control, perhaps most of the deleterious effects of diabetes can be attenuated or reversed,” Reiss said in a statement. “That’s the punchline, and it’s big.”

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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