Association of diabetes mellitus and structural changes in the central nervous system in children and adolescents: a systematic review

Abstract

BackgroundThe relationship between diabetes and academic performance have been of great interest to researchers during the year to date. Many studies have been conducted to discover this relationship during three recent decades. But, evaluation of the structural changes of brain in the context of diabetes is of paramount importance especially in children and adolescents.MethodsThis study is a systematic review conducted to investigate the structural changes in the central nervous system in children and adolescents living with diabetes. Among about 500 papers published in this area in Pubmed and SCOPUS, 13 articles in the field of assessing structural changes in the central nervous system in children and adolescents with diabetes mellitus were entered into the evaluation process.ResultsAs can be seen in these studies, a huge proportion of structures of the central nervous system have been affected by diabetes that include different areas of gray and white matters. In the majority of these studies, it has become clear that high glycemic changes, especially recurrent hyperglycemic attacks are very seriously associated with structural changes in the brain.ConclusionIt seems the findings of this review can positively aid other researchers to develop medical guidelines to prevent or resolve the brain changes in central nervous structure and consequently cognitive impairments in children and adolescents.

A Comprehensive Review of Neuronal Changes in Diabetics

“…On the other hand, cognitive decline and dementia seen in diabetes are also attributed to white matter disease. Patients with T2DM are more prone to dementia than T1DM due to associated metabolic risk factors like hypertension, obesity, and hyperlipidemia [107,117]. The white matter disease appears as hyperintensities on MRI and is due to microvascular changes in the cerebral vessels.…”

Changes in the Brain-Derived Neurotrophic Factor Are Associated with Improvements in Diabetes Risk Factors after Exercise Training in Adolescents with Obesity: The HEARTY Randomized Controlled Trial

“…Obesity is well known to increase the risk of T2D [ 6 ], and T2D in adulthood is one of the strongest independent risk factors for neurological disease [ 7 , 8 ]. In children and youth, recurrent hyperglycemia is associated with adverse structural brain outcomes, including reduced gray and white matters [ 9 ], suggesting that improving metabolic regulation early in life is important for long-term brain health. Although poorly understood, the proposed mechanisms contributing to increased risk of neurocognitive dysfunction with these conditions include poor glycemic regulation [ 10 ] and alterations in the brain-derived neurotrophic factor (BDNF) [ 11 ].…”

Brain functions and cognition on transient insulin deprivation in type 1 diabetes

“…Although the Diabetes Complications and Control Trial established a substantial reduction in microvascular complications, uncertainty remains on the impact of glycemic control and dementia ( 5 ). Recent work highlights the effects of chronic glucose excursions and variability on neuroanatomy and cognitive function ( 2 , 4 , 6 , 7 ). However, while past studies explored chronic dysglycemia ( 8 – 10 ) and the acute and selective effect of hyperglycemia in the presence of insulin ( 11 ), little is known about the effect of acute periods of insulin deficiency and resulting altered metabolic milieu on the brain ( 12 ).…”