For the study, the researchers measured gray matter densities in areas of the brain responsible for memory, language processing and attention. When they compared the images of 82 patients who had type 1 diabetes for 15 to 25 years with minimal complications to those of 36 age-matched control subjects who did not have diabetes, they discovered lower levels of gray matter density in the group with diabetes. Among that group, they also found that these lower levels in density were associated with poorer glycemic control and higher frequency of hypoglycemic events that led to unconsciousness.
"This study definitely does not mean that everyone who gets type 1 diabetes will suffer from clinically significant brain damage," Dr. Jacobson emphasizes. Indeed, he explains that in fact they observed little difference in cognitive function when patients with diabetes were compared to the participants in the control group. What is important, however, is the new tool researchers now have to examine what changes do occur, what drives them, and how they may affect brain functions, including those that lead to depression.
Understanding changes in brain structure becomes particularly critical as more and more people with type 1 diabetes are living longer lives, explains co-investigator Gail Musen, Ph.D., also of Joslin. "We want to be able to understand how the metabolic changes of diabetes affect the risks these patients face so we can find ways to minimize them as they go on to live 50 or more years with this disease."
Dr. Jacobson and his colleagues will continue now to follow the patients in the study to observe if and how the changes progress over time and whether high or low blood glucose influences that progression. Because they can also use MRI to measure the brain's response to stimuli like cognitive or em
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Contact: Marjorie Dwyer
marjorie.dwyer@joslin.harvard.edu
617-732-2415
Joslin Diabetes Center
31-Jan-2006